View Categories

MHN Incarceration & Suspension

Incarceration status does NOT impact eligibility for MHN. Participants cannot be closed or rejected because they are in jail or prison and must be treated the same as other participants for applications, renewals, and changes in circumstance.

MHN benefits must be suspended when a participant is incarcerated for more than 30 days and restored upon release from incarceration.

A specialized unit handles suspending and restoring benefits as well as inpatient events for participants who are currently suspended. All other actions must be completed by field staff.

MHN Definitions for Suspension: #

  • Offender- An inmate or resident of a public institution, including confinement in a local or state prison, jail, correction, detention facility or other penal facility, regardless of adjudication status.
    • Note: A participant who is on probation or parole is NOT incarcerated. This includes participants living in a private residence, group home, halfway house, or a Department of Corrections Transition Center.
  • Incarcerated Individual- An eligibly unit member who meets the definition of an offender and not receiving MHN benefits.
  • Incarcerated Participant- A participant who is activity receiving MHN benefits and becomes incarcerated.
  • Suspended Participant– A participant who is incarcerated and whose MHN benefits are suspended.
  • Redetermination- The process where FSD reviews eligibility factors prior to or upon release of a suspended participant.
  • Restoring Benefits- The process where FSD completes redetermination to continue eligibility and activate MHN benefits upon release from prison or jail.
  • Remaining Adult- The responsible adult who is still in the home when there is an incarcerated head of household.

MHN Applications for Incarcerated Individuals #

When an incarcerated applicant plans to return to their home upon release, FSD Field Staff processes their application as if they were living in the home. This means their home address may be used, and their spouse and/or children in the home are listed on the application. If the incarcerated applicant does not intend to return to their home, they may use the address of their facility and be processed as a single person household.

When an incarcerated individual is determined to be eligible for MHN, FSD Field Staff approve the application and send an IM-150 Suspending Incarcerated Participants form to Suspension SharePoint by uploading it to MHNJailsandDOCReport@ip.sp.mo.gov to request that their benefits be suspended. If the incarcerated individual is determined to be ineligible for MHN, FSD Field Staff reject the application, no further action is needed.

When an IM-150 is sent requesting that a participant’s benefits be suspended, the Specialized Unit confirms that the participant is incarcerated and completes the necessary actions to suspend their benefits.

  • Note: MXIX will reflect eligibility even when benefits are suspended. Benefits are suspended by Lock In, which can be seen on eMMIS or Health Track.

See 3.19.5 MO HealthNet Applications for Incarcerated Individuals for additional information.

MAGI MHN Applications with Incarceration Evidence #

When processing an application that has internal Incarceration evidence, where the participant is reporting incarceration information, please follow the steps below:

  1. Process the application the same way you would any other application including verifying evidence and making your application comments on the HOH person page.
    1. Complete all verifications prior to reviewing incarceration information in Step
      1. Note: It is important to remember that incarceration is not a cause for ineligibility.
  2. Review electronic sources for prisoner information:
    1. 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.
    2. Check Vinelink and the DOC Offender site to see if you can determine if the individual is incarcerated and when they were incarcerated.
      1. Note: A participant who is on probation or parole is NOT incarcerated. This includes participants living in a private residence, group home, halfway house, or a Department of Corrections Transition Center.
    3. Unable to determine if they were or are incarcerated – data sources neither confirm nor deny
      1. Call the participant to confirm incarceration information.
      2. If unable to reach them by phone move forward to Step 4.
  3. Update MEDES Incarceration evidence:
    1. If they were in custody (in the past) update the Incarceration evidence as follows:
      1. The Criminal Charges Status field need to reflect ‘Pending Deposition’.
      2. Ensure the start date & end date fields reflect the custody dates found on IIVE, the Vinelink site, or the DOC Offender site.
      3. Update or add the Institution name in the ‘Institution First Name’ field under ‘If the institution is not known to MEDES’ section.
      4. Make notes regarding the evidence on the HOH Person page and process the application like normal.
      5. DO NOT send an IM-150 requesting suspension.
    2. If they are in custody (currently) update the Incarceration evidence as follows:
      1. The Criminal Charges Status field need to reflect ‘Pending Deposition’.
      2. Ensure the ‘Start Date’ field reflects the date of the Application.
      3. Ensure the ‘End Date’ field reflects the expected release date if provided on the Vinelink site or the DOC Offender site.
      4. Update or add the Institution name in the Institution First Name field under If the institution is not known to MEDES section.
      5. Make notes regarding the evidence on the HOH Person page and process the application like normal.
      6. Additional action needed for suspension, move to Step 4.
  4. After processing the application run an Eligibility Check or apply changes.
    1. If eligible, approve and move to Step 5.
    2. If ineligible for any reason other than incarceration, authorize the denial. No further action is needed.
  5. After you approve an individual who is incarcerated, or someone whose incarceration status cannot be determined, complete an IM-150 Suspending Incarcerated Participants form with the information that you know and send the IM-150 to MHNJailsanddocreport@ip.sp.mo.gov. This is what notifies the specialized unit that a suspension needs to be entered or incarceration needs to be verified.
    1. Note:  Send the IM-150 to MHNJailsanddocreport@ip.sp.mo.gov even if it is already received completed with the IM-1SSL.

Non-MAGI MHN Applications with Incarceration Reported #

Follow the below steps when Incarceration is reported, or a match is found for a possible incarcerated applicant:

  1. Process the application the same way you would any other application by completing the controlled flow, complete Accuity check, and making your application comments on EUMEROL.
    1. Complete all verification process prior to verifying incarceration information in Step 2
      1. Note: It is important to remember that incarceration is not a cause for ineligibility.
  2. Review electronic sources for prisoner information:
    1. 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.
    2. Check Vinelink and/or the DOC Offender site to see if you can determine if the individual is incarcerated and when they were incarcerated.
      1. Note: A participant who is on probation or parole is NOT incarcerated. This includes participants living in a private residence, group home, halfway house, or a Department of Corrections Transition Center.
    3. If they were in custody (in the past):
      1. Complete actions as normal. DO NOT send an IM-150 requesting suspension.
    4. If they are in custody (currently) or Unable to determine if they are still  incarcerated – data sources can neither confirm nor deny.
      1. Process the application like normal and complete authorizations.
      2. Additional action needed for suspension, move to Step 3.
  3. After completing the application and authorizing actions:
    1. If eligible approve and move to Step 4.
    2. If ineligible any reason other than incarceration, authorize the denial. No further action is needed.
  4. After you approve an individual who is incarcerated, or someone whose incarceration cannot be determined, complete an IM-150 Suspending Incarcerated Participants form with the information that you know and email the IM-150 to MHNJailsanddocreport@ip.sp.mo.gov. This step is what notifies the specialized unit that a suspension needs to be entered or incarceration needs to be verified.
    1. Note:  Send the IM-150 to MHNJailsanddocreport@ip.sp.mo.gov even if it is already received completed with the IM-1SSL.

Annual Renewals and Change in Circumstances for Suspended Participants #

FSD Field Staff are expected to complete case actions if there is a suspended participant who remains in the household when a change is reported or an Annual Renewal. The specialized unit will only need to complete CIC/Annual Renewal actions when the suspended participants will not be returning home after incarceration.

Encountering Incarcerated Participant:

  1. FSD learns that a participant is now incarcerated and household members are currently receiving.
    1. FSD Field Staff are expected to complete all case actions if there is a suspended participant who remains in the household when a change is reported or while completing an Annual Renewal.
    2. Check person page and HOH person page to determine if suspension is already in place.
      1. Look for a comment with a subject similar to “Incarcerated Household Member.” This indicates the person was already suspended. No additional action is needed.
      2. Look for a separate comment “Redetermination of MO HealthNet,” “Unsuspend,” or “Ending Suspension,” or some variation.
        • If there is not one, then the person is already suspended and no action is needed unless they are not returning home after incarceration.
        • If there is one, then this is a new incarceration and FSD Field staff should continue to Step 2.
  2. FSD Field Staff confirm the participant is currently incarcerated.
    1. Review IIVE, VineLink, and DOC Offender Search.
      1. If the participant is not currently incarcerated, then no additional action is taken
      2. If the participant is currently incarcerated, continue to Step 2b.
    2. FSD Field Staff will update the case with the information received.
      1. FSD Field Staff will add to the comments made on the HOH Person Page the following information:
        • Subject Line: Incarcerated
        • Comment Body: Name of the incarcerated individual, how it was reported to FSD, who is currently receiving MHN, other details regarding the information learned, and that an IM-150 has been sent.
    3. FSD Field Staff will complete an IM-150 Suspending Incarcerated Participants form including additional relevant information in the “Any other information or changes that you need to report” section of the form and submit it to MHNJailsandDOCReport@ip.sp.mo.gov

Encountering Suspended Participants Not Returning Home:

  1. FSD receives a CIC or Annual Renewal.
  2. FSD Field Staff review comments and there is a household member who is suspended:
    1. Example Suspension Comment:
      1. Subject Line: Suspension of MO HealthNet [Date of Action, mm/dd/yy] – [Participant’s Name]
      2. Comment Body: Date incarceration was reported, how incarceration was reported, where the participant is incarcerated (facility name), expected/actual release date (if known), any other changes reported, any changes made to case (such as address and income), and date that IM-33 Suspend was sent to the participant.
  3. FSD learns that the suspended participant will no longer return to the home after incarceration.
  4. FSD Field Staff will complete an IM-150 Suspending Incarcerated Participants form and send it to MHNJailsandDOCReport@ip.sp.mo.gov.
    1. FSD Field Staff are expected to:
      1. Upload documents to the ECM appropriately
      2. Comment on the HOH Person Page:
        • Subject Line: Suspended participant who will no longer return to the home after incarceration.
        • Comment Body: Name of the suspended participant, how it was reported to FSD, who is the HOH, who is currently receiving MHN, other details regarding the information learned & an IM-150 was submitted.
  5. FSD Field Staff will NOT take further case actions after the IM-150 has been sent.

Restoring Benefits After Release from Incarceration #

When a participant is no longer incarcerated, FSD must restore their benefits as of the date of release. FSD Staff should update any contact or eligibility information that is available on their documents, or directly from the participant if they are on the phone or in person.

A suspended participant does not need to complete a new application when released from incarceration.

  1. FSD Field Staff fills out an IM-152 Restoring a Suspended Participant Change Report form including any additional known information in the “Any other information or changes that you need to report” section of the form and submit it to the SharePoint site, MHNJailsandDOCReport@ip.sp.mo.gov
    1. If the participant can provide verification of their release date, it should be submitted with the IM-152.
  2. FSD Field Staff are expected to:
    1. Upload documents to the ECM appropriately.
    2. Comment on the HOH Person Page:
      1. Subject Line: Requested End of Incarceration Suspension
      2. Comment Body: Name of the suspended participant, how it was reported to FSD, other details regarding the information learned, and date that the IM-152 was submitted.

See 3.19.9 Redetermination and Restoring Benefits After Release for additional information.

Inpatient Events for Incarcerated Participants #

When a participant, provider, or incarceration facility reports that the incarcerated participant had an inpatient event, where the participant was admitted to a hospital or other medical facility for 24 hours or more, then their MHN can be restored to cover those dates of service.

  1. If the participant has active MO HealthNet, or you approve an application, and they are not yet suspended:
    1. Complete an IM-150 Suspending Incarcerated Participants.
    2. Include information about the inpatient event in the “Other Information” field.
    3. Send to SharePoint: MHNJailsandDOCReport@ip.sp.mo.gov
  2. If the participant is already suspended:
    1. Complete an IM-151 Inpatient Coverage for Incarcerated Participants.
    2. Include as much information as you have and reference any relevant information that is in the ECM.
    3. Send to SharePoint: MHNJailsandDOCReport@ip.sp.mo.gov

See 3.19.8 Inpatient Services while Incarcerated for additional information.

 

 

 

Was this guide helpful?