Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: FEDERAL NOTICE REQUIREMENT FOR MO HEALTHNET (MHN) PROGRAMS
MANUAL REVISION #
0130.005.05.30 Federal Notice Requirements
FORM REVISION #
IM-4 MULTI LANGUAGE INTERPRETER SERVICES
IM-4 MHN NON-DISCRIMINATION ENGLISH VERSION
IM-4 MHN NON-DISCRIMINATION SPANISH VERSION
The Family Support Division (FSD) is introducing a new policy section, 0130.005.05.30 Federal Notice Requirements . This section is located within the Legal Aspects chapter of the General Info Manual under 0130.005.05 Availability of Information. Two new forms have been created, the IM-4 Multi Language Interpreter Services (IM-4 MLIS) and the IM-4 MHN Non-Discrimination (IM-4 MHND) (in English and Spanish).
Federal Regulation 45CFR 92.101-92.105, requires FSD to provide information about language services available to Medicaid participants. FSD will send the IM-4 Multi Language Interpreter Services (IM-4 MLIS) when notices and forms are sent to the participant in connection with their MO HealthNet eligibility.
Federal Regulation 45 CFR 92.1-92.6, requires FSD to provide information regarding prohibiting discrimination under any health program or activity receiving Federal financial assistance. The IM-4 MHN Non-Discrimination (IM-4 MHND) English and Spanish forms and the IM-4 Multi Language Interpreter Services (IM-4 MLIS) forms were created and are located in the Forms Manual.
Beginning June 1, 2021, FSD will systematically send an informational notice, the IM-4 Multi Language Interpreter Services (IM-4 MLIS), in addition to notices and forms sent from the eligibility systems. Additionally, FSD is systematically adding the Non-Discrimination statement, in both English and Spanish, to all Annual Reviews.
- Review this memorandum with appropriate staff.
- Staff will mail the appropriate form with MO HealthNet Applications, MO HealthNet Reviews, and MO HealthNet notices that are sent outside the system.
- MEDES will NOT show that the IM-4 MLIS or the IM-4 MHND were sent.