Page 14

BAM 301 14 of 14 AP CASE READING GUIDE BPB 2022-001 1-1-2022

BRIDGES ADMINISTRATIVE MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

4) Emergency Assistance SER Manual Note: Some of the questions listed below may be addressed under factors A through F of the reading form. The questions which are unique to SER are addressed here. • Is there a current signed DHS-1514 and DHS-1171 in the case? • Was the emergency request registered timely? • Is the emergency a covered service? • Were repeat request criteria and required payments correctly determined and documented? • Will the payment resolve the emergency? • If the emergency was approved, did the case meet the asset limit? • Was the need verified and documented? • Was all projected income for the 30-day budget period used in doing the budget? • Does the requested need meet the affordability criteria? • If there was excess income and/or cash assets, did the client make the copayment? • Were potential resources explored and necessary repay agree- ments signed? • Was the amount authorized within the maximum allowed? • If an exception was granted, is the necessary documentation in the case? • Was the client sent a DHS-1419?

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Page 14

Official source

BAM 301 14 of 14 AP CASE READING GUIDE BPB 2022-001 1-1-2022

BRIDGES ADMINISTRATIVE MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

4) Emergency Assistance SER Manual Note: Some of the questions listed below may be addressed under factors A through F of the reading form. The questions which are unique to SER are addressed here. • Is there a current signed DHS-1514 and DHS-1171 in the case? • Was the emergency request registered timely? • Is the emergency a covered service? • Were repeat request criteria and required payments correctly determined and documented? • Will the payment resolve the emergency? • If the emergency was approved, did the case meet the asset limit? • Was the need verified and documented? • Was all projected income for the 30-day budget period used in doing the budget? • Does the requested need meet the affordability criteria? • If there was excess income and/or cash assets, did the client make the copayment? • Were potential resources explored and necessary repay agree- ments signed? • Was the amount authorized within the maximum allowed? • If an exception was granted, is the necessary documentation in the case? • Was the client sent a DHS-1419?