A resident is any person who, at the time of application, voluntarily lives in the State and intends to remain permanently or indefinitely in the State. If the individual was placed in Missouri by another State, the individual is considered a resident of the placing State.
An individual does not have to maintain a permanent or fixed address in the state to be considered a resident of Missouri. Information about the address of those individuals in the eligibility unit is collected at the beginning of the interview process when the Supercase is established on the Supercase Member Clearance (SCMBR/FMOE) screen. Enter the client’s declaration about the residency requirement on the Resident (RESIDENT/FMAO) screen.
An individual currently living in Missouri can be a resident of Missouri and declare an intention to return to a former out-of-state residence at some indefinite future time.
Accept the applicant/participant’s statement of residency and intent to remain unless questionable.
EXAMPLE 1: Mr. T. has lived in California for nine years. He came to Missouri to visit relatives for a few days. While he was visiting he attained his 65th birthday, and decided to apply for Medical Assistance to help defray the cost of his doctor’s bills and his prescriptions. Mr. T. does not meet the residence eligibility requirement because he is only in the State temporarily, and does not intend to remain.
EXAMPLE 2: Mr. T. has lived in California for nine years. He is no longer employed and has decided to move to Missouri to be near his relatives. He is now 65 years old and needs some help with his medical expenses. He rented a room and moved his belongings to Missouri. He states that he would like to return to California someday. Mr. T. meets the residence eligibility requirement.
EXAMPLE 3: Mr. C and his spouse have resided at their home in Arkansas for thirty years. Mr. C’s health has deteriorated to the point that he requires care in a nursing facility. Mr. C decided to enter a skilled nursing facility in Missouri He is now a Missouri resident, while his wife maintains residency in Arkansas. They are not separated for any reason except that he is in a nursing facility in Missouri. A division of assets has been completed and he also gives his wife an allotment. Spouses can maintain residency in other states and not be considered separated and an allotment can be given to a spouse residing out of state.
Persons receiving Medicaid from another State can be approved for MO HealthNet from Missouri provided the person meets all Missouri eligibility requirements including residence. Applicants can be approved for MO HealthNet in Missouri prior to their Medicaid case being closed in another state. Duplicate participation is resolved through the Public Assistance Recipient Information System (PARIS) quarterly match. Any case involving cash assistance must be closed in the other state and it must be verified that payments from the other state have been discontinued before cash benefits can be approved in Missouri.
Factors of age, ability to declare intent to reside in Missouri, and emancipation are considered in determining residence.
An applicant/participant will be considered incapable of declaring intent if the applicant/participant:
is found incapable of indicating intent based upon medical documentation obtained from a physician, psychologist, or other person licensed by the State in the field of mental retardation.
NOTE: A separate medical evaluation or legal opinion is not necessary if this can be determined from medical information or copies of legal documents already maintained in the case record.
For individuals not living in an institution:
When determining residence for applicant/participants admitted to or residing in an institution that is:
If the applicant/participant is admitted to or residing in an institution, the criteria of age and the ability to declare intent must be considered in determining whether the individual meets the residence eligibility requirement.
For individuals living in an institution:
EXAMPLE: Mike C. is 22 years old. He has been institutionalized at a rehabilitation hospital in Illinois for two years for treatment of serious physical injuries and severe brain damage as a result of an automobile accident. Mike did not have a permanent address before he was injured when he was 20 years old. Mike’s parents live in Missouri and want to have him institutionalized in the State so he can be near them. Mike meets the residence eligibility requirement based on his parents’ residence and the fact that he became mentally incapable before he was 21.
For ANY OTHER INSTITUTIONALIZED individual, the State of residence is the State where the applicant/participant lives and intends to remain permanently or for an indefinite period of time.
If FSD is unable to determine the State of residence for an institutionalized applicant/participant who is incapable of declaring intent, the State of residence for the institutionalized applicant/participant is the State in which the institution is located. An applicant/participant may not be excluded from MO HealthNet coverage because FSD cannot determine the applicant/participant’s State of residence.
EXAMPLE: Mary P., age 87, is confined in a nursing facility in Missouri. She has no legal guardian. She is unable to communicate and it is not possible to learn when and where she became incapable of declaring intent. Her State of residence is the State in which the institution is located, in this instance, Missouri.
When a State arranges for or actually places an individual in an institution in another state, the placing State is considered the individual’s State of residence. When a State lacks the appropriate facilities and places an individual in an out-of-state institution, the placing State is the applicant’s State of residence.
Any agency of the State, including an entity recognized under State law as contracted with the State for such purposes, that arranges to place an individual in an institution located in another State is recognized as acting on behalf of the State.
Any actions that go beyond merely providing information to an individual or an individual’s family constitute arranging or making a State placement. A State that provides reimbursement for transportation to the other State is considered as having placed the individual and is responsible for the individual’s care. The following actions do not constitute State placement:
When a competent individual leaves an institution that was a State placement, that individual’s state of residence for MO HealthNet is the State where the individual is physically located.
When an applicant or participant temporarily leaves the State for purposes such as visiting friends or relatives, or securing healthcare, the applicant or participant’s residency is not affected.
When an applicant or participant moves to another State intending to live there permanently or for an indefinite period of time, assistance is discontinued because Missouri residence has been abandoned.
Temporary absences from Missouri, with the intent to return, do not affect continuity of residence and do not cause ineligibility for assistance. An individual may leave Missouri for a visit, business purposes, or other temporary reasons.
Covered MO HealthNet services may be available to Missouri residents temporarily absent from Missouri if:
Determination of continued residence is based:
Determine the applicant/participant’s reasons for leaving and the approximate length of time the applicant/participant expects to be away. When an applicant/participant’s temporary absence from Missouri is later found to be a permanent move with intention to remain elsewhere, immediately authorize actions in FAMIS to discontinue assistance.
When an MHABD applicant or participant expects to leave the State temporarily, the applicant/participant must:
If the applicant/participant plans to be out of the State for less than 90 days:
If an applicant/participant leaves the State WITHOUT PRIOR WRITTEN OR ORAL NOTIFICATION to FSD:
When an absence or continued absence from the State is necessary because of a physical or mental condition, continue assistance only in those cases where intent to return has been established. If the applicant/participant is married and living with spouse, the same criteria apply if continued absence is caused by a physical or mental condition of the spouse, regardless of whether the spouse is an applicant/participant.
To determine whether Missouri residence has been abandoned all pertinent information must be considered, including the following:
Continued maintenance of a home in Missouri, stored furniture, or definite ties to the community indicates a probable intent to return. The sale of property or removal of furniture and household goods to the other State indicates probable intent to abandon Missouri residence.
Where there is definite evidence the applicant/participant’s statement does not represent the actual situation, major weight will be given to actions indicating intention to abandon Missouri residence. If the applicant/participant declares intent to abandon Missouri residence, or if the applicant/participant’s actions indicate intent to abandon Missouri residence, authorize action in FAMIS to close the case or reject the application.
Base a participant’s continued eligibility on information collected before the participant left Missouri, together with information subsequently received and correspondence with the participant. Update the Personal Details (PRSNDTL) screen to show the out-of-state address as the mailing address. Generate a Review form in FAMIS from the TA/MA Review History (REINVEST) screen (F14=ADDREIN) for each case in which the participant is or plans to be out of State for 90 or more days regardless of when the last investigation was conducted.
Carefully review the completed MO HealthNet Eligibility Review Information (FA402) form to determine
When the review determines that residence has been abandoned, an Adverse Action to close the case should be authorized in FAMIS; except when it is verified by another state that they are receiving benefits, then a Worker Initiated Close must be authorized to discontinue benefits immediately.
If it is determined the applicant/participant is only temporarily absent and intends to retain Missouri residency:
If there is sufficient information to determine eligibility, do not correspond with the other State’s public assistance agency. However, if the information is too limited to determine eligibility, request the public assistance agency in the State where the participant is staying to contact the participant to obtain additional or substantiating information. Because the request is to acquire information not received from the participant the request letter must be very specific. Contact information for other States’ agencies is listed by state in the Public Human Services Agency Directory.