Family Healthcare (FAMIS) Manual – Table of Contents

0905.010.40.05 Referral To DCSE (MAF)

IM-#104, December 20, 2012IM-#205 November 29, 2001

Refer to FSD-CS MAF cases in which a child is deprived of parental support due to the continued absence of the child’s parent from the home. This policy also applies to MHF/MHK cases except for the following cases:

  • A child under the age of 19 who is not living with a caretaker and who applies for MC+ in his/her own name; and
  • A non-related caretaker applying for a child in their physical custody for whom they do not have legal guardianship or legal custody.

The MHF/MHK application form (IM -1UA) includes pertinent absent parent information.  The client has met initial cooperation requirements if they provide the information requested on the IM – 1UA.

A CS-201 must be completed, but is not required prior to approval.  Do not hold an application pending completion of the CS-201.  If the applicant is unavailable to sign the CS-201 (mail-in application), the CS-201 may be mailed to the applicant or completed by the caseworker during a telephone call.

If the CS-201 is completed by telephone call, a signature is not required.  Make a notation in the signature section the information was obtained by telephone, along with the date of the call, and send to FSD-CS.

If not completed by telephone or in person, a CS-201 should be mailed to the applicant with a self-addressed envelope.  Include a Request for Information (IM-31A) notice allowing 10 days to return the completed CS-201.

If the CS-201 is not received by the date of approval, send another Request for Information (IM-31A) notice advising the applicant they have 10 days to provide the completed CS-201.  If the CS-201 is not received during this 10-day period, initiate adverse action to sanction the caretaker on the Sanction/Disqualification Screen (FMAM/SANDISQ) Type (NCM) non-cooperation with medical support.  Enter comments supporting the sanction decision, including attempts to obtain the CS-201.  FSD-CS should be sent the appropriately completed CS-201 or an IM-16 notifying FSD-CS a sanction was imposed.

NOTE:  Staff should have the CS-201 completed by the applicant if the application is made in person.