SR 08-03 Dated 01/08

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

SUMMARY

This SR releases:

§   the elimination of the personal interview for certain individuals discharged from New Hampshire Hospital (NHH) within 60 days of admission, who are re-applying for financial and/or medical assistance;

§   a streamlined application process for the adult categories of medical assistance and Healthy Kids for inmates of New Hampshire State Correctional Facilities (SCF) with an approaching release date; and

§   expanded eligibility for adult categories of medical assistance and Healthy Kids for SCF inmates who become inpatients in a medical facility while incarcerated.

This SR also releases the obsolescence of the following forms and their associated instructions:

§   Form 819, Financial Assistance for Unemployed Parent (UP) Worksheet;

§   Form 820, AFDC-UP Work History Worksheet; and

§   Form 822, Unemployment Compensation History Inquiry.

POLICY

Reinstatement of Assistance for Individuals Discharged from New Hampshire Hospital (NHH)

Individuals who are terminated from financial or medical assistance due to admission to NHH and are discharged within 60 days from the date of admission do not have to attend a personal interview to reapply for financial or medical assistance if the individual:

·   submits a completed Form 782, New Hampshire Hospital Discharge Request for Reinstatement of Financial and Medical Assistance; and

·   provides verification of all changes that have occurred since the individual’s last redetermination.

A personal interview is required, however, if any of the following conditions exist:

·   a redetermination was due or overdue when the individual was admitted to NHH;

·   a redetermination is due the month the individual is discharged from NHH;

·   the Disability Determination Unit determined that the individual failed or refused to cooperate without good cause with any medical review process; or

·   the individual wants to apply for:

-   a category of financial or medical assistance the individual had not received prior to admission; or

-   assistance other than financial or medical assistance, such as Food Stamps or Child Care assistance.

Inmates with an Approaching Release Date

Inmates of SCF with an approaching release date may apply for medical assistance while still incarcerated. Eligibility must be confirmed within the normal processing time frames, but not before the individual is released from prison.

Inmates Who Become Inpatients in a Medical Facility While Still Incarcerated

Inmates of SCF are retroactively eligible for the adult categories of medical assistance and Healthy Kids during any period the inmate becomes an inpatient of a medical facility.

Note: Any request for retroactive assistance must be made no later than 9-months from the first date of the coverage period requested.

PROCEDURES

Reinstatement of Assistance for Individuals Discharged from NHH

Upon receipt of Form 782, New Hampshire Hospital Discharge Request for Reinstatement of Financial and Medical Assistance, determine whether or not the individual is required to attend an interview. If an interview is required, contact the designated case technician in the Office of Reimbursements at NHH and inform them that an interview is required.

If an interview is not required:

1. review Form 782 and the attached documentation to assure that all changes since the individual’s last redetermination have been verified;

2. request any additional verifications from the designated case technician at NHH;

3. enter the application information into New HEIGHTS, using the date received as the application date;

4. select cash and/or medical on the "Program of Assistance" screen to correspond with the benefits received prior to NHH admission;

5. enter the patient’s date of discharge as the effective date on the "Program of Assistance" screen;

6. change the redetermination date in New HEIGHTS to match the redetermination date the individual had before his or her admission to NHH; and

7. confirm the financial and/or medical assistance after:

·   verifying that all necessary documentation has been received; and

·   contacting the designated case technician in the Office of Reimbursement at NHH on the date of discharge to verify the patient’s discharge.

Inmates with an Approaching Release Date

Personnel at the Department of Corrections (DOC) are responsible for identifying potential Medicaid applicants from the pool of individuals who are approaching their release date from prison. DOC personnel will interview the applicants, collect all needed verification, and send the application packet with new cover memo Form 786, Inmate Application Cover Sheet, to the appropriate District Office (DO) through inter-office mail. A single point of contact in each DO has been identified to receive the application packages. Upon receipt of the packet, the single point of contact will:

1. enter the application information into New HEIGHTS using the date received as the application date;

2. enter the individual’s living arrangement type as "Independent Housing Unit;"

3. send all required forms and medical information to the Disability Determinations Unit (DDU) if a medical decision is a program requirement;

4. enter the individual’s date of release as the effective date on the "Program of Assistance" screen;

5. confirm the medical assistance case once:

·   all necessary medical decisions have been made by DDU; and

·   the DOC has contacted the single point of contact on the date of release to verify the individual’s discharge; and

6. fax the updated Form 786 to the DOC in 2 days from the date the case is confirmed to inform them of the individual’s eligibility status.

All determinations must be made within the normal processing timeframes, but not before the individual is released. As such, if an individual is:

·   determined eligible by DDU prior to release, do not confirm the case until the DOC verifies the release date; and

·   not released by day 88 for APTD/MEAD or by day 43 for all other medical assistance programs, deny the application by changing the individual’s living arrangement type to "Incarcerated."

Inmates Who Become Inpatients in a Medical Facility While Still Incarcerated

Upon receipt of the application packet for retroactive medical assistance, the single point of contact will:

1. enter the application information into New HEIGHTS using the date received as the application date;

2. use the correctional facility as the primary address on the "Household Information Screen," and as the "Household Mailing Address" (the correct address can be found on the back of new Form 786, Inmate Application Cover Sheet);

3. enter the acronym "DOC" (use all capital letters) on the "Care of" line of the "Household Mailing Address" Screen;

4. enter the individual’s living arrangement type as "Independent Housing Unit;"

5. send all required forms and medical information to the DDU if a medical decision is a program requirement;

6. confirm the medical assistance case:

·   once all necessary medical decisions have been made by DDU; and

·   only for the period of time the individual was an inpatient in the medical facility.

FORMS REVISIONS

Form 782, New Hampshire Hospital Discharge Request for Reinstatement of Financial and Medical Assistance, and its associated instructions have been revised to further clarify that only TANF/Adult financial and medical assistance can be reinstated.

Form 786, Inmate Application Cover Sheet, and its associated instructions were created to assist DHHS and the Department of Corrections in determining eligibility for adult categories of medical assistance and Healthy Kids for inmates who:

·   have an approaching release date; or

·   become inpatients of medical facilities while still incarcerated.

Form 786 will be printed on bright yellow paper. This bright yellow color will serve as a visual cue for the DO point of contact to identify an inmate’s application package for medical assistance.

UNRELATED FORMS OBSOLESENCE

Because the following forms have been automated in New HEIGHTS, the paper versions are no longer used:

§   Form 819, Financial Assistance for Unemployed Parent (UP) Worksheet;

§   Form 820, AFDC-UP Work History Worksheet; and

§   Form 822, Unemployment Compensation History Inquiry.

As such, the forms and their associated instructions are obsolete effective with the release of this SR.

POLICY MANUAL REVISIONS

Revised Family Assistance Manual Topics

Section 307.01  Eligibility Within Institutions

Section 307.07  Financial and Medical Assistance: Public Institutions (New Hampshire Hospital)

Section 307.11  Medical Assistance: Inmates

Revised Adult Assistance Manual Topics

PART 163  REDETERMINATION OF ASSISTANCE FOR INDIVDUALS DISCHARGED FROM NH

HOSPITAL (NHH)

PART 175  MEDICAL ASSISTANCE FOR INMATES

Section 175.01  Inmates With an Approaching Release Date

Section 175.03  Inmates Who Become Inpatients in a Medical Facility While Incarcerated

PART 307  INSTITUTIONS

IMPLEMENTATION

The policies released in this SR are effective as follows:

§   the simplified financial and medical assistance reapplication process for individuals discharged from NHH within 60 days of admittance is retroactively effective to January 19, 2007.

§   the simplified medical assistance application process for inmates approaching their release date is retroactively effective to October 2, 2007.

§   the expanded medical assistance eligibility for inmates who become inpatients at a medical facility while incarcerated, and the obsolescence of Form 819, Form 820, Form 822, and their associated instructions, is January 1, 2008.

CLIENT NOTIFICATION

No special notification is planned or necessary.

TRAINING

Training for DOC staff was held on Tuesday, September 25, 2007 at Eagle Square.

FORMS MANUAL POSTING INSTRUCTIONS

DISPOSITION

This SR may be destroyed or deleted after its contents have been noted and the revised manual topics released by this SR have been posted to the On-line manuals.

DISTRIBUTION

This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR, and revised On-Line Manuals, will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at http://www.dhhs.nh.gov/DHHS/DFA/LIBRARY, effective March 3, 2008.

This SR, and printed pages with posting instructions, will be distributed under separate cover to all hard copy holders of the Forms, Family Assistance, and Adult Assistance Manuals.

DFA/MPM:s