Welcome to the Missouri Department of Health and Senior Services (DHSS) online administrative and data collection form. All subrecipients are required to submit one online form per calendar year per taxpayer identification number (nine digit number), regardless of the number of contracts or agreements with DHSS or the number of business locations.
IMPORTANT NOTE: The form only works when using browsers other than Microsoft Internet Explorer, such as Chrome, Edge, Firefox, Opera, Safari, etc.
There is not a Save feature for the form. If you have to close out and return at a later time/date you will have to begin the process over again. Information needed to complete the process:
- your organization’s federal taxpayer ID#;
- your organization’s DUNS number and Parent DUNS number if there is one (you may find your DUNS number by going to http://www.dnb.com/duns-number/lookup.html;
- access to or knowledge of organizational written policies and procedures; and,
- a copy of your most recently completed audit or financial review.
If applicable, a copy of your organization’s most recent audit or financial review must be sent to DHSS, except federal Single Audits. Single Audit reports are required to be uploaded to the Federal Audit Clearinghouse at https://harvester.census.gov/facweb/.
Copies of audit reports other than Single Audits, plus any additional attachments may be sent:
- via the preferred method, email, to email@example.com:
- or by regular mail to
Missouri Department of Health and Senior Services
Division of Administration
PO Box 570
Jefferson City, MO 65102-0570
If you have a federal indirect cost (IDC) rate, email a copy of the negotiated IDC rate agreement to ProcurementUnit@health.mo.gov. For information regarding negotiated indirect cost rates, please refer to §2 CFR 200 Appendix III, IV, or V as applicable.
Some questions on the form have help links to assist in selecting the response that best fits your organization. If you have additional questions regarding the completion of this form, you may contact the DHSS Division of Administration at 573.526.0387.
Please make sure that you have enough time to complete the form prior to starting. It may take several minutes to complete. Prolonged periods of inactivity will cause your login to expire.