- ALL FAMILY SUPPORT DIVISION OFFICES
- PATRICK LUEBBERING, ACTING DIRECTOR
- COMBINED TEMPORARY ASSISTANCE, FOOD STAMP
AND MO HEALTHNET APPOINTING AN AUTHORIZED REPRESENTATIVE (IM-6AR)
FORMS MANUAL REVISION #3
This memorandum will introduce the new combined Appointing an Authorized Representative (IM-6AR) form. The new IM-6AR will replace the previous IM-6AR, IM-6ARO, FS-6ARF, and the FS-6ARI. The revised form will be used for Temporary Assistance, Food Stamps, MO HealthNet for the Aged, Blind, and Disabled (MHABD), and MO HealthNet for Families programs.
NOTE: Temporary Assistance uses Protective Payees, not authorized representatives.
Effective with this memo do not accept older versions of the IM-6AR, IM-6ARO, FS-6ARF, or FS6ARI.
At each FAMIS MO HealthNet reinvestigation review the Representative List (AUTHREP) screen in FAMIS. If the begin date of the authorized representative listed is prior to the date of this memo, a new form is necessary. Take the following steps to request an updated form.
- Manually send a Request for Information (IM-31A) along with the revised IM-6AR to the participant with instructions to complete, sign, and return the IM-6AR within 10 days.
- Make a comment on EUMEMROL and AUTHREP screens, indicating it sent and when it is due.
- If the IM-6AR is returned, end the existing AR and re-enter with the new information.
- If the IM-6AR is not returned, take action to end the AR.
NOTE: The staff member who sends the IM-31A and IM-6AR to the participant is responsible to verify if the IM-6AR was returned, and take actions instructed above.
At each MO HealthNet for Families program reinvestigation in MEDES, review the representative information as detailed in EMAIL-IM-32 from July 5, 2016. If the begin date of the authorized representative listed is prior to the date of this memo, a new form is necessary and should be sent to the client along with a Request for Information (IM-31A). Staff should make the appropriate notes in MEDES to capture the authorized representative information.
- Review this memorandum with appropriate staff.
- Destroy all old versions of the IM-6AR, IM-6ARO, FS-6ARF, and FS-6ARI.
- Begin using the revised IM-6AR effective immediately.
- Appointing an Authorized Representative (IM-6AR)
- Appointing an Authorized Representative (IM-6AR) Instructions