MEMORANDUM

2015 Memorandums

IM-#17      03/18/15

DEPARTMENT OF SOCIAL SERVICES
FAMILY SUPPORT DIVISION
P.O. BOX 2320
JEFFERSON CITY, MISSOURI
TO:
ALL FAMILY SUPPORT DIVISION OFFICES
FROM:
ALYSON CAMPBELL, DIRECTOR
SUBJECT:
MO HEALTHNET SINGLE STREAMLINED ADDITION (IM-1ADP)

DISCUSSION:

The purpose of this memorandum is to clarify when to use the MO HealthNet Single Streamlined Addition IM-1ADP.

The IM-1ADP should be used in the following circumstances:

Household consists of more than two persons.

Refer to IM-#105; 11/20/13 2013 MO HealthNet Single Streamlined Addition (IM-1ADP) for original instructions.

If the IM-1SSL application is made available without speaking to a FSD staff, also make the IM-1ADP available. If the household size is known when mailing an IM-1SSL, include as many IM-1ADP forms as appropriate.

The participant contacts a FSD office to add a person to an active Family MO HealthNet case.

FSD staff may use the IM-1ADP as a tool to help capture needed information to add a person to an existing case.  Use one form for each person requesting to be added.  Make a note on the top of the form to indicate it is an add-a-person request and follow existing intructions to scan to the FSD WorkSite and index under budget adjustment/change report. To ensure the person is added to the correct household enter the head of houshold’s name and Departmental Client Number (DCN)/Social Security Number (SSN) in the spaces provided at the top of each IM-1ADP.  See below.

IM1-ADP

NOTE: First Responder staff should also utilize the IM-1ADP when a request is received to add a person to an active Family MO HealthNet case.  Use existing procedures to notify appropriate MAGI Processing Center staff.

NECESSARY ACTION:

AC/tb


2015 Memorandums