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 #
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