The Medical EDBC Summary page is viewed during the eligibility process prior to accepting EDBC.
Begin Month and End Month show the dates of the EDBC record.
NOTE: If there is no End Month – this means the EDBC is high-dated and has not ended. Since the EDBC is high-dated this is the consumer’s current eligibility. Prior Medical months are never high-dated.
Run Date shows the date EDBC was run.
Run Status shows one of these values:
Not Accepted
Accepted – Not Saved
Accepted – Saved
Accepted By shows who accepted the EDBC result:
Worker’s Name
Manual EDBC
Batch Process
The EDBC Information block shows the type of EDBC:
Regular
Read Only – No Benefits Issued to MMIS as previous EDBC was run and accepted
EDBC Source:
Online EDBC Rules – Eligibility was determined by rules
Batch – The process of automatically running EDBC for cases that meet predetermined criteria
Manual – Eligibility was determined off system and the outcome was recorded in KEES
Program Status:
Active
Denied
Discontinued
Name Hyperlink
When clicking the Name hyperlink, the Individual Eligibility Criteria page is displayed. This page shows potential eligibility for medical programs. It also shows financial and non-financial criteria used in making the determination.
Role shows only one of these values for PPS:
MEM (Member)
FRI (Financial Responsible Included) – not applicable for PPS
UP (Unaided Person) – not applicable for PPS
Role Reasons - not applicable for PPS Foster Care or Adoption Assistance
Status is whether the consumer is:
Active – at least one eligible program person
Denied – at initial application and all program persons are deemed ineligible
Discontinued – after program is ‘Active’ and EDBC is recalculated determining all program persons are no longer eligible due to changes in the program
Ineligible – when running EDBC is attempted for a prior saved benefit month Status Reason displays if the consumer has been Denied or Discontinued
Not applicable for PPS. This block is used to determine if the program is eligible to receive assistance under the Elderly and Disabled program eligibility criteria. Fields include:
Name
Adult/Child
Aged 65 or Older
Receives Medicare
Declared Disability
Active Disability
Resource Test – Not applicable for PPS Foster Care or Adoption Assistance
CSRA Determination – Not applicable for PPS Foster Care or Adoption Assistance
This block shows the EDBC rules results for an Eligible Budget, Potential Eligibility, and Failed and Overridden Budgets.
Eligible Budget – shows the program which eligibility was determined for based on medical hierarchy
Potential Eligibility – not applicable for PPS (shows other ‘possible’ medical program eligibility)
Failed and Overridden Budgets – not applicable for PPS
Result column under the Eligible Budgets block shows Pass
FPL% - not applicable for PPS
Premium/LTC Liability/Spenddown – not applicable for PPS
Aid Code is the state assigned classification determined by the program applied for and on the consumer’s eligibility determination.
Example: FCM/DC/N/N which translates to Foster Care Medical for DCF case/Not Sobra/Not Inmate
LTC Details show the Long Term Care specific criteria.
Example: HC/HC/SE which translates to Home and Community Based Services with waiver for Severe Emotional Disturbance Member Tested shows consumers tested and passed.
Role values include:
MEM (Member)
FRI (Financial Responsible Included) – not applicable for PPS
UP (Unaided Person): displays on converted programs – not applicable for PPS
Role Reasons pertain to individual eligibility and display if the consumer is not a MEM. They explain why the individual is not considered in the budgeting unit. Not applicable for PPS.