Complete a review of BP eligibility every 12 months. Every review or change in circumstances requires appropriate action and recording.
When one or more changes occur, evaluate which eligibility factors may be in question to determine whether a complete reinvestigation is necessary or whether a review of certain eligibility factors will suffice. This may include: marriage, appointment of guardian, change in living arrangements, or change in income.
Reviews of BP cases are to be done annually. The review should be completed through the mail. A face-to-face interview is not required. A review can be completed without a review form (IM- 2U), if all the information is obtained. If eligibility can be established from information in existing records (Food Stamps, spouse's MA case, etc.), a review form is not necessary. A case may not be closed for failure to return a review form, or complete an annual review, if continued eligibility can be established based on available information from other sources.
When completing a review, resource documentation and the eligibility determination should be recorded.
BP recipients are required to report changes in circumstances affecting eligibility factors within ten calendar days of the change. If the reported change in circumstances (address, income, resources, etc.) indicates a lower level of care or ineligibility, notify the claimant of any action precipitated by the change within ten days of the date the claimant reports the change.
Claimants who plan to enter or currently reside in a nursing facility, IMR, or State Mental Hospital may be eligible for MA or BP vendor payments made to the facility on their behalf.
When a BP recipient or blind applicant is residing is in or plans to enter a nursing facility, IMR, or MHC, eligibility for vendor must first be explored under MA. If ineligible under MA, BP vendor eligibility will be explored if the claimant is in a nursing facility or MHC. IMR coverage is not available under BP state only medical assistance.
Refer to Medical Assistance policy for information on determining eligibility and transferring a case to vendor payments. If eligible for MA vendor, close the BP case and open the MA case on the same day. If the BP claimant cannot meet MA eligibility, change the BP case from cash to vendor for claimants certified for NF or MHC level of care. The process for determining vendor eligibility and level of care under BP is the same as the process for MA vendor, except:
When a BP cash or vendor recipient enters an institution for the intellectually disabled (IMR), follow adverse action procedures to close the BP case. At the same time register a MHABD case and determine if the claimant is eligible MHBABD vendor with an IMR level of care.
If it appears that a BP claimant would be eligible for another type of assistance, such as SAB or MA, take action to evaluate eligibility and transfer the BP case to the other category of assistance when eligible.