- TO:
- ALL FAMILY SUPPORT DIVISION OFFICES
- FROM:
- JULIE GIBSON, DIRECTOR
- SUBJECT:
- HOME AND COMMUNITY BASED SERVICES REFERRAL FORM (IM-54A) REVISION
DISCUSSION:
The purpose of this memorandum is to introduce a revision made to the Home and Community Based Services Referral Form (IM-54A).
Income Maintenance Memo IM-#76, dated 08/12/2015 introduced the Home and Community Based Waiver (HCB) processing center (PC) located in Poplar Bluff, MO.
The IM-54A has been revised to ensure the form is returned to the HCB PC. The form now includes the Poplar Bluff HCB PC:
- Address;
- Phone number; and
- Email address
The Department of Health and Senior Services (DHSS), Division of Senior and Disability Services (DSDS) will complete the assessment and return it to the HCB PC.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
- Immediately begin referring individuals to DSDS using the revised IM-54A.
- Destroy versions of the IM-54A with revision dates prior to 09/15.
JG/HA