Do not automatically deny the applications but call the Trafficking Verification line at (202) 401-5510 for assistance. When unearned income fluctuates, compute it on an annual or other representative period and convert it to a monthly amount. Cubans and Haitian entrants defined in Section 501(e) of the Refugee Education Assistance Act of 1980; Immigrants for whom deportation or removal has been withheld under either 243(h) or 214(b)(3) of the INA; Trafficking Victim, as defined by the Trafficking Victims Act of 2000; Department of Health and Human Services (HHS) Office of Refugee Resettlement (ORR) has been delegated the authority to conduct certifications for victims for trafficking. The applicant or participant's failure to participate in locating the non-custodial parent without good cause may result in a determination of refusal to cooperate and the application of a sanction. Applications for children under age 1 (MHK under 1) whose mother was not active Title XIX coverage on the baby’s date of birth are not automatically eligible for Newborn coverage during the first year of life. The H-call for citizenship returned conflicting information; it showed that Xavier has only been in the United States for three years. Do not deny or delay the approval pending the citizenship/proof of qualified immigrant status documents. Payments received by any member of the Aroostook Band of Micmacs pursuant to the Aroostook Band of Micmacs Settlement Act (Public Law 102-171). EXAMPLE 3: Mrs. Smith is applying for MO HealthNet for Families (MHF) for herself and her six children. When the custodial parent cannot be determined by the tax filing status continue to step 2 of this section. Self-attestation is accepted unless it is questionable. The eligibility specialist made an error considering information that was available. When the SSN/proof of application for a SSN or applicable federal identification number is received, or the participant has submitted proof they have ordered a birth certificate, and all other eligibility criteria are met, approve the Family MO HealthNet application. The good cause for counseling is limited to three months. Refer to MAGI Manual section 1805.020.05.05 Documents to Verify Citizenship for information on acceptable citizenship documentation. The Federal Data Hub (Federal level information from the IRS.). If unable to contact applicant by telephone, mail a Request for Information (IM-31A) allowing 10 days for the applicant to complete and return the form. Chapter 15 - Supplemental Nutrition Assistance Program (Food Stamps) Chapter 19 - Energy Assistance. A Request for Information notice is sent to Ms. Jones to request proof of application for a SSN. You will ONLY look at the percentage at the bottom of the calculator. In order to calculate the 5% disregard you will need to know that 100% of the annual federal poverty level for a household of four is $25,100.00. The evaluation is valid for two years unless the mental health professional or Income Maintenance staff determines that another evaluation is needed. Completed by the Family Support Division staff during a telephone call with the applicant prior to approving the application. Use the rules in this section for the specified types of income. If the previous 30 days does not accurately reflect a projection of ongoing income request further pay history to accurately project income.  See MAGI Policy Manual, 1805.030.25.05 Projection of Income. Dad receives MHF if he and the child meet all eligibility factors. The applying individual MUST sign the SS-5 prior to being submitted to the SSA Office. The five percent (5%) disregard replaces earned income disregards previously used to determine eligibility for the Family MO HealthNet programs. In the following situations actual income is used: Claims that are established based on the projection of income are because one of the following applies: Always record a comment regarding the projections of income. 5% of FPL is added to the 150% CHIP standard (5% + 150% = 155%); Multiply $25,100 X 155% which equals $38,905.00. For additional information, refer to section 1805.030.15 Reasonable Compatibility. The Missouri Adoption Subsidy Program is authorized by sections 453.065, 453.073 and 453.074, RSMo, and permits the Division to make subsidy payments on behalf of eligible special needs children to adoptive families to cover maintenance, medical and dental care, and other special expenses. Grandmother is a non-parent caretaker who receives MHF if she and at least one of the granddaughters meet all eligibility factors. Average past earnings to determine the representative monthly amount to project income. Half-time, part-time, or homeschool teachers do not qualify for an educator expense deduction. Letter from Secretary of State John Ashcroft 3. In order to calculate the 5% disregard you will need to know that 100% of the annual federal poverty level for a household of three is $20,780.00. It is the responsibility of Income Maintenance staff to make the final determination. Before the expiration of the Adverse Action Notice, Ms. Jenkins provides a letter from the United States Citizenship and Immigration Services (USCIS) explaining the paperwork delay. Enter a comment providing details on how the FSD assisted with the application for SSN, when the SSN application was made, etc. Note: The application for SSN from the Social Security Administration office must be received prior to allowing the 90 day Reasonable Opportunity period. FSD-CS will use the email address FSD.GROUPC@dss.mo.gov when sending a request to enter MO HealthNet sanction due to non-cooperation in pursuit of medical support, or to end a sanction when the individual cooperates with CS. 0820.030.15 – Income and Budgeting. A partnership interest in land, land, or an interest in land received from a Native Corporation as a dividend or distribution on stock. NOTE: Count a child’s income only when that child must file taxes on the income. Official Manual Title Page 2. Birth or baptismal certificate issued on a reservation; Letter from the Canadian Department of Indian Affairs; or, Unexpired temporary I-551 stamp in foreign passport or on Form I-94 with the code AM1, AM2, or AM3. To determine the CHIP 75 income level including the 5% disregard: Since Mr. Jones’ income of $5,199.60 per month is below $5,2282.00 (305% of FPL) his children are eligible for CHIP 75 level of care. EXAMPLE 1: Mr. Jones is applying for CHIP on behalf of his two children. For self-attested income to be considered confirmed, the income should meet criteria in one of the following bullets.  Apply the following order when confirming income. It does not apply to parents or children included in the household who are not requesting benefits. If the self-attested amount is not RC, additional information should be requested. The person is not claimed as a dependent on someone else’s tax return. Incidents of domestic violence resulting in physical or emotional harm to the child, applicant, or participant. Emails received from CS requesting entry or ending of a child support sanction will contain “Child Support Sanction" in the subject line. when making application for a SSN. In determining eligibility based on MAGI methodology, use the following calculations: NOTE: See sections on included income, excluded income, and allowable deductions for examples. If an individual has a SSN but does not know it, provide a Request for Information (IM-31A) and allow ten days to provide the SSN. A statement given under oath to a notary public is the most common and most available type of sworn statement. If the self-attested income is below the threshold and the electronic data source income are within 10% of each other, the individual's income is reasonably compatible.  Use the self-attested income for the budget and eligibility determination. If the individual has not reported an employer or income source, and the electronic data source has information of an employer or income source, contact the participant for clarification. This may include: Do not deny, delay, or discontinue assistance pending a determination of good cause for refusal to cooperate. Self-attested income is used.  Individual is eligible.  10% Reasonable Compatibility Test is not required. When other allowable deductions are not reported or they are unknown, make an eligibility determination without applying the deduction. birth certificate, marriage certificate, etc.) NOTE:  The documents listed above may include, but are not limited to: NOTE:  In Missouri, LOC of "G" (newborn coverage) on the MXIX screen verifies this factor. Complete the budget based on Ms. Johnson's normal wages of $10.00 per hour for 40 hours per week. When an applicant does not already have a SSN at the time of the Family MO HealthNet application: NOTE: Under 42 CFR 435.910, FSD staff must assist applicants in obtaining a SSN. The participant must provide the required verification within ten (10) days from the date that the FSD requests the information in writing. This is called the 10% Reasonable Compatibility Test. Her income varies from pay period to pay period depending on her production. Always begin by looking at the income as a whole. NOTE: A verified SSN is NOT a verification of citizenship. To determine how much pay history to use for individuals whose income is inconsistent it is important to ask why the income is inconsistent and if they anticipate any changes.  Gather as much information as possible to make an accurate determination of ongoing income.  Record a detailed comment explaining how the pattern and calculation of income was determined. Let’s presume you’re applying for a mortgage with your spouse. Assist the applicant or participant to complete the necessary information on the CS-201. NOTE: MEDES verifies a participant’s citizenship and immigration status by: EXCEPTION: The DHS SAVE system does not contain information about victims of severe forms of trafficking. Income Standard for household size of selected program: Electronically-Obtained Income (EOI) converted to a monthly amount: Electronically Obtained Income (EOI) converted to a monthly amount: Include the full amount of any lump-sum SSA benefit payments received in current tax year. When evaluating the length of time to use in determining patterns of income for projecting future income, always consider information from at least the past 30 days. Do not deny or close an application or case for verification of deductions. Relationships to persons of preceding generations as denoted by prefixes of grand, great, or great-great. Once you receive that verification, determine if it is reasonably compatible with their original statement. Use the pay stubs as verified income evidence. Low Income Housing Tax Credit (LIHTC) - Manual available on this page: click here. Certificate of Citizenship (N-560 or N-561). He deposits $50 of his earnings into his own ABLE account. That income is taxable and counted under MAGI methodology; NOTE: Include as income any of the above grants available to students for current living expenses (grants - educational expenses = money available for current living expenses). The value will be accepted as fair market value unless the value can be shown to be otherwise. When the self-attested income is not RC with the EOI further clarification is required from the individual to substantiate the self-attested income. Review court orders, legally binding separation orders, divorce decrees, parenting plans, and/or custody agreements to determine which parent is the custodial parent. NOTE: Whether the difference is within 10% or not, income is not considered RC and additional verification will need to be requested. Ask him/her to submit all information available to verify the claim. For children under age 19, a clinic, doctor, hospital, or school record, including preschool or day care records. The Eligibility Specialist, with supervisor approval, voids the adverse action, and sends a new Request for Information providing Ms. Jenkins with a 30 day extension of the reasonable opportunity period. This is the monthly figure for 155% of FPL; Round up $3242.08 to $3243.00. NOTE: For an individual to qualify as attending an eligible education institution, they must receive Form 1098-T from the education institution. If the location is unknown, the applicant or participant will be asked to provide information that may lead to possible sources for obtaining this information. Explore RC with all available EOI before requesting additional information/clarification from the individual. Use past patterns of income if these patterns will continue. Example: Ms. Jones applies for Family MO HealthNet coverage as a qualified immigrant, but does not include a SSN or applicable federal identification number on her application. Mom is a non-tax filer and Dad is a tax filer. WV INCOME MAINTENANCE MANUAL Work Requirements 13.3 3/07 450 12a working 30 hours a week and is not exempt from the work requirements, a penalty is applied. See Income Maintenance Manual sections 1805.020.10.10.05 and 1805.020.10.10.10 for policy on the five year ineligibility period and exceptions to the five year period of ineligibility. If the MO HealthNet application was completed on-line, by telephone, or by mail, the CS-201 may be: NOTE: If completed by telephone call send the CS-201 to FSD-CS and note the information was obtained by telephone in the signature section along with the date of the call. MO HealthNet program's income threshold for the household size, MHF – MHF income limit for household size, Children under the age of 1 – 196% of the FPL, MHK for children age 1 to age 18 – 148% of the FPL. NOTE:  If our records indicate a different employer/income source than what is self-attested, do not request verification that the income source in our records has ended unless it is questionable or not compatible.  End the income source in our records based on self-attestation. If an applicant or participant claims good cause based on physical harm and no evidence exists to verify the claim, request a written explanation for the record. - Management/Maintenance Plan Outline available on this page: click here. However, non-modifiable maintenance will generally terminate upon the death of either party or upon the remarriage upon the party receiving maintenance. This program was first effective September 28, 1973. The household for a tax filer consists of the following individuals: The household of the tax dependent is the same as the tax filer’s household; unless the tax dependent meets one of the exceptions in 1805.030.10.20 Exceptions to MAGI Household Composition. NOTE: FSD determines if good cause exists; refer to 1805.040.10.15.05 Determining Good Cause. The program was designed to remove barriers that kept people with disabilities from choosing to work for fear of losing health care coverage. Certificate of Naturalization (N-550 or N-570), and. Individuals exempt from providing documentation of citizenship and identity are listed in Section 1805.020.05. If the applicant provides documentation with an immigrant registration number, use the VLP Scan and Upload process to send documentation to the DHS to verify immigration status. Therefore, tax documents will not include verification of pre-tax deductions. For children newborn up to but not including age 16, identity can be verified by the signature of a parent/related caretaker/legal guardian on the application or reinvestigation forms. A parent or caretaker must complete a Referral/Information for Child Support Services (CS-201) form, but the form is not required prior to approval of the MO HealthNet case. In this instance, the monthly figure of $5281.58 would be rounded up to $5282. Section 1903(x) of the Social Security Act states that individuals who are eligible for MO HealthNet or CHIP as "deemed newborns" are considered to have provided satisfactory documentation of citizenship and identity (by virtue of being born in the United States) and will not be required to further document citizenship or nationality at any subsequent MO HealthNet or CHIP eligibility determination or redetermination. Chapter 3 - County Reimbursement (moved to 13 CSR 40-108) Chapter 7 - Family Healthcare. Obtain a SSN for all individuals including children under one requesting benefits at the time of the initial application whenever possible. These deductions can be found on IRS form 1040, lines 23-35. Individuals denied due to failure to apply for, or disclose an existing SSN must verify they have complied to be eligible. The MAGI households for each applicant would be as follows: EXAMPLE THREE: Grandmother and two granddaughters (both under age 19 and sisters) live together. Refer to Appendix A in the Family Healthcare Manual (MAGI) for. Qualified immigrants entering the U.S. on or after August 22, 1996 who are members of one of the groups listed below have no waiting period: Qualified immigrants entering the U.S. on or after August 22, 1996 who are not eligible for MO HealthNet for five years following their date of entry are listed below. Comments on the case must support what was used to verify eligibility factors. Participants with income above 100% Federal Poverty Level (FPL)of the will pay a premium to receive coverage. The MAGI households for each applicant would be as follows: EXAMPLE TWO: Mom and Dad, not married, both over age 19, live together, and have a child (age 3). These payments are authorized under Section 105 of Public Law 100-383, the Civil Liberties Act of 1988; Restitution payments not exceeding $12,000 received by Aleuts who were interned during World War II. Household composition based on non-tax filer rules includes family members who live with the individual. NOTE: When applying the 10% Reasonable Compatibility Test and one of the household member's income passes the 10% Reasonable Compatibility Test and another household member's income fails, only request a reasonable explanation/clarification for the income that failed the test. If a former foster care individual has been determined ineligible for a Family MO HealthNet full coverage program through FSD, the Eligibility Specialist (ES) will send an email to Cole.MHNPolicy@dss.mo.gov so that the individual may be referred to the CD for coverage as eligibility for the Former Foster Care Youth program may exist. At application, provide a Request for Information (IM-31A) form allowing 10 days to apply for a SSN or provide the SSN. Linda states she has Lauren more than 50% of the time. Once the Adverse Action Notice (IM-80) expires, discontinue coverage for all participants for whom documentation of citizenship or qualified immigrant has not been provided. (2) Change Reporting AG’s 1. Ms. Jenkins fails to provide documentation of qualified immigrant status by November. She lives with the father of her children but she is not married to the father. After discussing with Ms. Smith variations in her earnings over the past several months, the most recent 30 days are not an adequate representation of her earnings. Additional evidence may be requested when evidence provided by the applicant or participant does not provide enough information to make a good cause determination. Refer to section 1805.040.10.20 for sanctioning procedures. Allow reasonable opportunity for persons requesting benefits who do not have citizenship documents/proof of qualified immigrant status or a SSN at the time of application. Use the prorated amount in determining eligibility according to regular budgeting procedures. Losses are commonly found on IRS Form-1040 identified with the sum amount showing in parenthesis () and may be found on one of the following lines: Line 17 – Rental Real Estate, Royalties, etc. Contributions to Individual Retirement Accounts (IRA’s). Non-qualified immigrants are ineligible for MO HealthNet benefits. Count as income TRA and TAA payments for living expenses (room, board, clothing, etc.). The individual must provide proof that they have made application through the Social Security Administration Office. ), Quarterly Wage Matches/New Hire Matches (State level information from DOLIR. Amount paid for health insurance when an individual is self-employed. See Income Maintenance Manual section 1510.020.00 for more information on victims of trafficking. NOTE: When an individual cooperates, CS sends a request to FSD to lift a sanction. To determine the MHF income level including the 5% disregard: Since Mrs. Smith’s income of $519.00 per month is below $649.00 (MHF standard plus 5% of FPL) she and her children are eligible for MHF level of care. Any siblings and stepsiblings, who are dependent children (children under the age of 19). Auxiliary aids and services are available upon request to individuals with disabilities. Income of individuals or households attesting zero income must be confirmed.  Treat self-attestation of no income the same as self-attestation of income. INCOME MAINTENANCE MANUAL INCOME MAINTENANCE MANUAL. DHS will determine the authenticity of the document and determine whether immigration status is met. Social Security, VA, State Employees, etc.,) but occasionally is paid early or late, consider the income in the month normally received. State Symbols of Missouri 5. Dad is claiming the child as his dependent. This is the annual figure for 155% of FPL; Divide $38,905.00 by 12 which equals = $3,242.08177.50 per month. A character of discharge "Under Honorable Conditions" is not an "Honorable" discharge for these purposes. Effective January 1, 2014, the Patient Protection and Affordable Care Act (PPACA or ACA) of March 2010 requires household composition to be determined using Modified Adjusted Gross Income (MAGI) methodologies per 42 CFR 435.603 (f). $649 is the MHF income standard including the 5% disregard for this household size. Section 1805.020.15 lists acceptable documents to use as verification. Convert this to monthly income by multiplying $460 x 4.333 = $1993.18. If an ineligible alien applies for healthcare coverage and states they have had no emergency care, do not process the application as an EMCIA request. However, neither spouse can deduct more than their own expense, up to $250. NOTE: DO NOT CONTACT THE NONCUSTODIAL PARENT UNDER ANY CIRCUMSTANCES. Immigrants from Micronesia, Palau and the Marshall Islands have signed a Compact of Free Association with the United States, which allows them to enter and leave the U.S. at will. Cooperation by the applicant or participant may reasonably be anticipated to result in physical or emotional harm to the: Applicant or participant so serious that it reduces his/her capacity to care adequately for the child; or. Is actuarially sound as measured against the life expectancy tables published by the Office … Allow the caretaker to continue to receive the current level or benefits until the hearing decision is rendered. A deduction for penalties paid for early withdrawal of savings from certain financial accounts. The Eligibility Specialist sends Ms. Jenkins an Adverse Action Notice (IM-80) to discontinue MO HealthNet coverage. Self-Employed SEP, SIMPLE, and Qualified Plans. Again, Ms. Smith does not provide verification of citizenship for herself or her children. 104-208; An American Indian born in Canada, if s/he is at least one-half American Indian blood; Trafficking Victim, as defined by the Trafficking Victims Act of 2000. NOTE:  If our records indicate a different employer/income source than what is self-attested, and the employers/income sources are compatible, do not request verification that the income source in our records has ended.  It is appropriate to accept self-attestation in this situation. Claiming the child as a tax dependent can demonstrate an assumption of primary responsibility, however it is not the sole determining factor.  A caretaker relative must live in the same household as the dependent child, assume primary responsibility, and be related to the dependent child. See 1805.015.00 SOCIAL SECURITY NUMBER for exceptions. NOTE: Social Security Numbers issued to non-citizens are allowable since the individual may have qualified immigrant status. In other situations such as new employment, no recent past earnings records exist to use as a guide. The following steps should be taken prior to referring a MO HealthNet case to FSD-CS when a child is deprived of parental support due to the continued absence of the child's parent/s from the home. Mr. Jones is employed and earns $30.00 per hour working 40 hours per week or $5199.60 per month ($30.00 x 40= $1,200.00 x 4.333). Amount of Maintenance in Missouri. The income is considered RC when the self-attested income falls below the MO Health Net program income threshold and EOI falls above, and the EOI is within 10% of the self-attested amount. Send an email, with a subject line of AC ME 38 - NEEDS TO BE CLOSED to Cole.MHNPolicy@dss.mo.gov. This disregard applies to the following programs: MO HealthNet for Families (MHF) eligibility is not based upon a percentage of federal poverty level. This applies only to the federal program specifically titled College Work Study. If a reasonable explanation is not given or the explanation given is not reasonable, request further verification. Dad is claiming the child as his dependent. Section 1902(a) of the Social Security Act requires individuals to apply for and provide a Social Security Number (SSN) as a condition of eligibility for MO HealthNet. Because of H-call and other electronic sources, the individual does not have to provide the same verification(s) to multiple agencies. Use the Communication Transmittal (IM-16) to notify the child support specialist of a good cause claim when a Referral/Information for Services (CS-201) has already been sent; Assist the applicant or participant in obtaining evidence when necessary. If a participant provides a SSN, but does NOT claim citizenship or qualified immigrant status, do NOT pend the application for citizenship/qualified immigrant status and do NOT provide a 90 day reasonable opportunity period. The immigrant’s date of entry into the United States. Allow the following expenses as deductions from an individual’s Adjusted Gross Income: NOTE: A student loan is not considered qualified when: 1) any of the proceeds of the loan were used for purposes other than the qualified higher education expenses, 2) the loan proceeds were borrowed from a relative, or 3) the loan proceeds were borrowed from a qualified employer plan. This signature is considered an affidavit to the child's identity. RC does not need to be explored as the pay stubs are considered verified and reflect information more recent than the EOI. 1850.020.20.10 Income Limits; 1850.030.00 Prior Quarter (PQ) and Month of Application Eligibility; 1850.040.00 Healthcare Coverage. Send an Adverse Action Notice (IM-80) to discontinue MO HealthNet coverage for all members for whom citizenship documentation has not been provided, and. Reasonable opportunity applies to the 90 day period participants are given to provide: NOTE: Section 6036 of the Deficit Reduction Act of 2005 (DRA) states that when documentation of citizenship includes proof of identity, the application may be approved pending documentation of citizenship even when proof of identity has not been provided. The applicant is a child under the age of 19 who is not living with a caretaker and who applies for Family MO HealthNet in his/her own name, A non-related caretaker is applying for MO HealthNet benefits for a child in their physical custody for whom they do not have legal guardianship or legal custody. NOTE:  Pay history from the past 30 days may not accurately reflect a projection of ongoing income when the individual is a seasonal worker, income includes overtime, the individual was on leave without pay, the individual started or stopped a job, etc. NOTE: Family Support Division (FSD) must check the electronic data sources to obtain information regarding the individual or household’s circumstances whenever possible. In this example it appears the children are not eligible for a non-premium level of care as the income maximum for non-premium CHIP coverage is $3,138.00 per month. Types of included income under MAGI methodology include but are not limited to: NOTE: Prior to processing the eligibility determination, the following must be sent with a Request for Interpretation of Policy (IM-14) through the proper supervisory channels: These will be reviewed by MHN Program and Policy and/or Division of Legal Services staff and the response will include a decision on whether or not the income is countable for MAGI programs. Ms. Johnson's projected monthly income is $1993.18. The purpose of the Ticket to Work Health Assurance (TWHA) program is to provide medical care for persons with disabilities, age 16 through 64, who are employed. Self-attested income and the electronic data source income are reasonably compatible, see, If the self-attested income is not reasonably compatible, the individual should provide a clarifying statement that reasonably explains the difference between self-attested income and the electronic data source income information; OR. The individual’s new workplace must be at least 50 miles farther from the person’s old home than the old home was from the old workplace.
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