Special Assistance for Adults SA-3120 EIS Instructions for SA

VII. CHANGE IN AMBULATION CAPACITY (“B” and “C” TO “H” OR “H” TO “B” and “C”)

Do not transfer cases from SA/IH (“H”) to SA/ACH (“B” or “C”) or from SA/ACH (“B” or “C”) to SA/IH (“H”). If an SA/IH recipient chooses to enter an adult care home and requests SA/ACH, a new application is required. The same is true for SA/ACH recipients who choose to return home and request SA/IH.

Key the DSS-8124, Application Processing screen, in EIS as a reapplication.

Use the DMA-5022 screen in EIS to issue supplemental payments when a recipient changes living arrangement and ambulation capacity.