Policy History for  5.13.6 ENROLLMENT/DISENROLLMENT AND INTERCOUNTY MOVES

Release 07-04

5.13.6 ENROLLMENT/DISENROLLMENT AND INTERCOUNTY MOVES

5.13.6.1 Enrollments

The enrollment date is always the date that the client is enrolled in the CMO.  The Resource Center worker provides the IM worker with this information.

5.13.6.1.1 Urgent Services

Determine Family Care eligibility for a person who received urgent services as of the date the CMO began providing services.  The CMO is paid the capitated rate as of that date, if the person is found eligible and chooses to enroll.

If the person is found ineligible for Family Care, the CMO bills the client for the care and urgent services it provided.  

5.13.6.1.2 SSI Recipients

A full MA application or review is not necessary for an SSI recipient who asks to enroll in Family Care, and is not applying for FoodShares.  The RC worker will supply the IM worker with the following information:

1. Name.

2. Residence Address.

3. Mailing Address.

4. SSN (and MAID number if different).

5. Sex.

6. Primary Language (English or Spanish).

7. Guardian/Power of Attorney Name and Address.

8. Date of Birth.

9. Race (Optional)

10. Citizenship Status (Alien registration number, if not a citizen).

11. Disability Status (if not age 65 or older).

12. All information necessary to complete screens ANCW, AFME, ANMC and ANFR.

They may use the “Model Agency Referral Form” to provide this information.  Workers can contact clients as needed for additional information.

5.13.6.2 Disenrollment

5.13.6.2.1 Adverse Action Disenrollment

CARES Client Assistance for Re-employment & Economic Support populates the date when there is ineligibility for FC.  It is not worker enterable.  The date will be an end of month date according to adverse action logic, except when the client dies.   In this case, the disenrollment date is the date of death.  

If a client asks to disenroll prior to the date set according to adverse action logic, fax the paper disenrollment form to the DHCF Enrollment Specialist at (608) 261-7793.  The request will then be forwarded to EDS for entry in MMIS.

5.13.6.3 Inter-county Moves

When a FC enrollee moves permanently to a non-CMO county, s/he can remain enrolled in the CMO only if the Resource Center worker informs IM that the following four conditions are met:

1. S/he is eligible for COP Community Options Program or waiver services.
   After moving to the new county, the enrollee resides in a long-term care facility ( Nursing Home, CBRF, or AFH ).

2. The enrollee’s placement in the long-term care facility is done under and pursuant to a plan of care approved by the CMO.
    

3. The enrollee resided in the CMO county for at least six months prior to the date on which s/he moved to the non-CMO county.

This page last updated in Release Number : 02-04

Release Date : 10-01-02

Effective Date : 10-01-02