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VIII. SAIH Requests and Processing for Individuals

Approved for TCL

A. The LME/MCO transition coordinator has been instructed

to directly contact the original Special Assistance/Medicaid

County DSS of eligibility as soon as it is determined that

the individual may be appropriate for SAIH.

1. After the direct contact with the DSS income maintenance or

SA/Medicaid supervisor, the transition coordinator has been instructed

to send the DSS-0034 Appendix E, Supplement 2, checking the “Request SAIH Eligibility” and other sections completed as needed and as information in known at that point.

2. After the direct contact with the DSS IMC, the LME/MCO transition

coordinator will continue to use the DSS-0034 Appendix E,

Supplement 2, to officially communicate the following:

a. Request for SAIH determination; .

b. Report private living address within 5 calendar days of the

Individual approved for TCL moving into a PLA.

c. Changes in planned living arrangement

d. Changes in county of PLA. Any/all other changes that are

pertinent to the determination of SAIH.

B. Receipt and Confirmation of the Request

1. If the DSS receives the DSS-0034 Appendix E, Supplement 2 only

from the LME/MCO and no direct contact, accept this document

as a request for SAIH and contact the LME/MCO transition

coordinator to verify receipt of the request.

2. If the DSS that is contacted is NOT the Special Assistance/Medicaid

County DSS of eligibility, the DSS will inform the LME/MCO of the

correct DSS county of eligibility and provide contact information for

that DSS.

SA-5250 VIII.