MEMORANDUM

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:

• An applicant indicates his/her household consists of more than two persons when applying for Family MO HealthNet programs and filling out the IM-1SSL, and;
• The participant contacts a Family Support Division (FSD) office to add a person to an active Family MO HealthNet case.

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.

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:

• Review this memorandum with appropriate staff.
• Make available the IM-1ADP and begin utilizing it for add-a-person requests.

AC/tb