Page 35
processing or place case in suspended status. Contact the LME/MCO
transition coordinator and inform him or her that if the DSS-5023 is not
received, the funds will be placed on an EBT cash card. If the individual
has an FNS case, the funds will be placed on the FNS EBT Cash Card.
If all eligibility criteria are met, and the DSS-5023 has not been
received, issue benefits to the client at the client’s new address on an
EBT Cash Card, informing all parties.
D. SAIH Applications for an Individual Approved for TCL with
No Active SA Case
1. A TCL individual may already be living in a PLA or may be recently
discharged from a State Psychiatric Hospital and may be homeless.
2. This situation requires a face-to-face interview and a completed
DSS-8190 SSI/Non-SSI Application Workbook. This policy has been
communicated to the LME/MCO, however, if a request arrives via the
DSS-0034 Appendix E Supplement 2, inform the LME/MCO
immediately of the requirement for a face-to face application interview.
3. Before the SAIH application can be dispositioned, the LME/MCO
transition coordinator will provide to the DSS IMC in writing on the
DSS-0034 Appendix E, Supplement 2, confirmation that the Case
Management Assessment has been completed.
4. Determine information relevant to establishing SAIH eligibility the
same as for other SAIH cases.
5. As always process as soon as possible, but no later than processing
deadlines in SA-5100.
6. Once all needed information has been received from the LME/MCO transition coordinator, determine eligibility. If the individual is eligible for SAIH, complete a DSS-8108SA, Notice of Special Assistance Approval and send to the beneficiary, authorized representative and LME/MCO transition coordinator. Inform on the notice that the individual is eligible for Special Assistance In-Home. The authorized payment amount and payment begin date will also be included.
7. If individual is found not eligible for SAIH, deny the application and
send a DSS-8109, Notice of Denial.
SA-5250 VIII.