Family Healthcare (FAMIS) Manual

0950.010.05 QUALIFIED ENTITY RESPONSIBILITIES

The qualified entity is responsible for screening all families who come to the entity for services to see if they are interested in healthcare coverage for their children.

If the family requests healthcare coverage for their children, the qualified entity will:

  • Have the parent/caretaker complete as much as possible of the MO HealthNet for Kids, Pregnant Women and Parents application (IM-1UA). Give the applicant the cover page of the IM-1UA when completed. Section A, B and C of the IM-1UA are required for PE determinations. Do not delay presumptive eligibility determination if other sections are incomplete.
  • If the child resides with a natural or adoptive parent, the parent must complete the application. If the child is residing with an adult other than the parent(s), this non-parent caretaker must complete the MO HealthNet for Kids, Pregnant Women and Parents application. The applying parent or non-parent caretaker can be under age 19.
  • Make an eligibility determination for presumptive MO HealthNet coverage for the children under age 19 on the IM-1UA based on the parent/caretaker’s statement with regard to gross income (no deductions) and assistance group size.

When determining the number of persons to include in the assistance group and whose income is considered, include children under 19 and their parents. The included person’s income is considered in determining eligibility for presumptive. Non-parent caretakers and their income are excluded.

The qualified entity is also responsible to:

  • Designate a member of the entity’s staff to be a liaison with FSD.
  • Maintain copies of the IM-1UA, PC-1 and PC-2 on all Presumptive Eligibility for Children determinations.
  • Have trained staff members available to make presumptive eligibility determinations.