Decide eligibility for Moms and Babies for all pregnant women, before you deny an application.

  1. (FCRC/All Kids Unit) Ask for information needed to verify eligibility.
  2. (FCRC/All Kids Unit) Decide Moms and Babies eligibility based on the information from the application interview if the applicant misses a scheduled appointment or fails to provide the requested verifications.
  3. (FCRC/All Kids Unit) Include in the case record a copy of Form 2383A to document that Moms and Babies eligibility was considered and the result.
  4. (FCRC/All Kids Unit) If the applicant is ineligible for Moms and Babies, specify the reason.
  5. (FCRC/All Kids Unit) Deny the application if the applicant(s) is ineligible for all programs.

To approve Moms and Babies, complete a blank Form 552 to include Moms and Babies eligible persons in the family on one Form 552 along with anyone eligible for Assist.

  1. (FCRC/All Kids Unit) Follow WAG 25-08-01-b to complete Form 552 except:
    Item 28 - Enter G if the only person is the pregnant woman. Leave blank otherwise.
    Item 39 - Enter 80 to suppress the central notice if there are additional family members approved for spenddown.
    Item 60 - Enter EDD (Expected Delivery Date) and the month and year (MM/YY) of the expected delivery date. For example, if the expected delivery date is 07/31/02, enter EDD 07/02.
    Item 75 - Enter SSN, if available.
    Item 78 - Enter P.
    Item 80 - Enter 159 CI. Enter the amount of countable income under AMOUNT. Enter the number used for the Moms and Babies Income standard under PERSONS.
  2. (System) Sends Notice of Decision on Application for Cash, Medical and/or Food Stamps (Form 360C), if the person is approved for Moms and Babies.
  3. (FCRC/All Kids Unit) Complete and send Form 360D and Form 360 for approval of a person for Moms and Babies if the case is being approved as a spenddown for other family members.
  4. (FCRC/All Kids Unit)Put the correct TAR message on the denial notice for a person ineligible for Moms and Babies.
  5. (FCRC/All Kids Unit) Send Notice of Change During the Enrollment Period for Pregnant Women and For Children (Form 2434D), to notify a pregnant woman about changing the case from Spenddown to Moms and Babies. The Form 2434D is used to notify a client of a change due to:
    • a case review,
    • REDE, or
    • backdating at intake.
  6. (FCRC/All Kids Unit) Use Form 2434D to notify a client about a change in case number because of combining a Moms and Babies case with a Spenddown case.
  7. (FCRC/All Kids Unit) Distribute Form 2434D:
    • original to pregnant woman;
    • copy in the combined Moms and Babies and Spenddown case record; and
    • copy in the companion case record, if appropriate.