IM-123 UPDATES TO THE MO HEALTHNET (MHN) ADD A PERSON FORM (IM-1ADP)

Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri

TO:  ALL FAMILY SUPPORT OFFICES

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  UPDATES TO THE MO HEALTHNET (MHN) ADD A PERSON FORM (IM-1ADP)

FORM REVISION #

IM-1ADP
IM-1ADP (Spanish)

 

DISCUSSION:

Updates have been made to the English and Spanish versions of the IM-1ADP. This form is for use when the head of household would like to add a person to an active MHN case. An application is not needed to add a person.

Updates include the following:

  • Instructions for assistance in obtaining Social Security Numbers have been added;
  • Military-service related questions have been added; and
  • Language has been updated to clarify what the form is used for.

Begin using the updated IM-1ADP effective immediately when the head of household makes an add-a-person request.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Access and print IM-1ADP forms from the DSS Forms Manual.
  • Use forms with the revision date of 11/2021.
  • Discard any forms with older revision dates.

 

KE/kg