DMH Consumers in a State Mental Hospital

  • Center for Behavioral Medicine
  • Fulton State Hospital
  • Hawthorn Children's Psychiatric Hospital
  • Metropolitan St. Louis Psychiatric Center
  • Northwest Missouri Psychiatric Rehabilitation Center
  • Southeast Missouri Mental Health Center
  • St. Louis Psychiatric Rehabilitation Center

DMH Consumers in a State Mental Hospital Coversheet

Please use the coversheet linked above any time you submit an application for a DMH Consumer in a State Mental Hospital.

Send applications, MRT packet, medical records, and verification to the address listed on the coversheet: DMH Medicaid Unit

Age 22-65 in DMH Psychiatric Hospitals

These clients are not eligible for MO HealthNet coverage, but there are special procedures in place to get them coverage once they are discharged.

Pre-Discharge Procedures 

Patients in Department of Mental Health (DMH) Division of Behavioral Health (DBH) state mental hospitals between the ages of 22 and 65 are not eligible for MO HealthNet coverage, but there are special procedures in place to get them coverage quickly once they are discharged.  DMH and the Family Support Division (FSD) have developed procedures for FSD to accept and process applications for these patients being discharged from DBH state mental hospitals so that coverage can be approved within two working days of the discharge providing all other eligibility factors are met.

As part of this process, DBH staff at the facility will assist the individual, the guardian, or authorized representative in completing the application and all necessary forms. The forms, and any verification, including medical documentation to establish a disability (if necessary) are to be submitted with the above Coversheet to the DMH Medicaid Unit at address listed on the coversheet.  The DMH Medicaid Unit will then send the application to the designated FSD office for processing.  The designated office is FSD DBH Processing office, 101 Park Central Square, Springfield MO 65806.

An application may be submitted as early as 90 days prior to an individual's planned discharge date. The date of application will be the date the application is received at the FSD DBH Processing office.  Include on the coversheet the anticipated discharge date and the name and contact information for the Community Mental Health Center (CMHC) or other DMH Case Management Agency that will be providing mental health services upon discharge.   Immediately upon discharge DBH staff at the facility need to notify the DMH Medicaid Unit of the date of actual discharge and the updated community address for the applicant.

Prior to the actual discharge FSD request any needed verification not provided with the application from the individual, authorized representative, or guardian.  To insure DBH staff at the facility are aware of any requested verification, a staff member at the facility needs to be designated by the patient or guardian as the authorized representative for the patient.

If the patient is ineligible on any factor other than residing in a public institution, FSD may reject the application when that determination is made.

If the patient is eligible on all factors other than residing in a public institution, FSD will hold the application until the discharge date or the due date, whichever is earlier.

If the individual is still residing in an institution on the due date, FSD will reject the application. DBH facility staff will need to submit a new application if discharge is still planned.

The due date for applications based on disability or blindness is 90 days from the date of application.  The due date for applicants eligible in the Adult Expansion Group (AEG) category is 45 days.

If the patient is discharged on or prior to the due date, FSD will approve the application within two (2) business days of discharge (if notified by the facility) into the community if eligible on all factors other than being in the institution.

NOTE: FSD will not approve an applicant until confirmation is received from DBH the DMH Case Management Agency that the individual was discharged from the facility. 

Under age 21 and 65+ in a Vendor/Medicaid certified bed

For patients under the age of 21 who are in a Vendor/Medicaid certified bed or any patient age 65+ who are in one of the above institutions the following steps should be taken to submit an application:

  • If the client is under age 21 and not in a Medicaid Certified bed they will not be eligible until discharge.
  • The client must be under 21 when admitted in order to be covered; coverage will continue until their 22nd birthday.
  • Patients under age 21 at Hawthorn are eligible whether or not they are in a Medicaid Certified bed.
  1. Assist the DMH Consumer with completing the application.
  2. Complete the MRT Packet with the client. Skip this if the client is 65+ and/or if the client receives SSD/SSI.
  3. Complete the Aged, Blind, and Disabled supplement form.
  4. If the client is under 21 and in a Vendor/Medicaid Certified bed complete the IM-71. If this does not apply, skip this step.
  5. If the client is 65+ and in a Vendor/Medicaid Certified bed complete the DA124A/B and submit it to DHSSCOMRU (Central Office Medical Review Unit). If this does not apply, skip this step.
  6. Gather verification of income (other than SSD/SSI) and resources, including but not limited to
    • Bank accounts/patient accounts
    • Stocks, bonds, CDs, trusts
    • Income from pensions or other sources
  7. Regardless of age, if the client is in a Medicaid Certified bed submit all of this verification including the IM-71 where applicable.
  8. Submit the application and any supporting documents with the DMH Consumers in a State Mental Hospital Coversheet.

Any time you have questions about the application process, case status, or general questions about MO HealthNet please email DMH.MedicaidElibility@dmh.mo.gov with the client’s name and DCN or DMH ID.