- TO:
- ALL COUNTY OFFICES
- FROM:
- ALYSON CAMPBELL, DIRECTOR
- SUBJECT:
- ADDENDUM TO THE MO HEALTHNET SINGLE STREAMLINED APPLICATION
DISCUSSION:
The purpose of this memorandum is to introduce the Addendum to the MO HealthNet Single Streamlined Application (IM-1SSL-ADD), for use effective October 1, 2013. Use the addendum for all Family MO HealthNet (FAM) applications received using a MO HealthNet Single Streamlined Application (IM-1SSL) form.
This memorandum contains information on the following:
- REASON FOR THE ADDENDUM
- WHEN TO USE THE ADDENDUM
- HOW TO OBTAIN ANSWERS FOR THE ADDENDUM
- AVAILABLITY OF THE ADDENDUM
REASON FOR THE ADDENDUM
The IM-1SSL was introduced in Income Maintenance memorandum IM-86 MO HealthNet Single Streamlined Application dated September 27, 2013.The streamlined application was required to be available as of October 1, 2013. The IM-1SSL was created to capture information necessary to complete a FAM application under policies that will be implemented on January 1, 2014.
The IM-1SSL-ADD has been created to assist field staff in obtaining information required for a current FAM determination in FAMIS that is not captured on the IM-1SSL.
WHEN TO USE THE ADDENDUM
Use the IM-1SSL-ADD beginning October 1, 2013, when individuals are applying for the following Family MO HealthNet programs:
- MO HealthNet for Families (MHF)
- MO HealthNet for Kids (MHK)
- Children's Health Insurance Premium (CHIP)
- MO HealthNet for Pregnant Women (MPW) and
- MO HealthNet for Uninsured Women's Health Services (UWHS)
Continue to use the IM-1SSL-ADD from October 1, 2013 through December 31, 2013. Discontinue use of this form as of January 1, 2014.
HOW TO OBTAIN ANSWERS FOR THE ADDENDUM
- If the application is completed in person, please follow instructions provided in IM-86 (2013), asking the questions of the applicant as they come up in the FAMIS controlled flow.
- If the application is submitted by mail, fax, or drop off, the Eligibility Specialist (ES) should contact the applicant by telephone to obtain the necessary answers to complete a current MO HealthNet FAMIS controlled flow.
- The attempted contact should be noted in FAMIS EUMEMROL, whether successful or not.
- If the contact attempt is unsuccessful, the ES should mail an IM-1SSL-ADD to the applicant, requesting return of the completed addendum within 10 days.
- If the IM-1SSL-ADDis not returned within 10 days, the ES may reject for failure to cooperate as we are unable to complete the FAMIS controlled flow to make an eligibility determination.
AVAILABLITY OF THE ADDENDUM
Due to the limited applicable timeframe for the use of the addendum, it will not be made available in the Forms Manual. Please use the version attached to this memorandum, and print or make copies as needed.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
- Begin using the IM-1SSL-ADD effective October 1, 2013.
ATTACHMENT:
AC/mh