Enrollment & One-e-App

1.  The new “REMOTE MHLA ENROLLMENT/RENEWAL FORM”
2. REMOTE MHLA ENROLLMENT/RENEWAL FORM Completion Instructions

One-e-App (OEA) is the eligibility and enrollment web-based system used by Health Services for submitting My Health LA electronic applications. Community Partners will enroll and renew participants exclusively through this County approved system. No paper applications will be accepted. OEA is designed to screen and refer applicants to other publicly funded health programs as needed.

1. OEA Training Rev 3-16-22
2. MHLA & OEA Reference Manual Rev April 2022
3. MHLA Enroller Training Support Structure Rev March 2022

1. Documents Received and Uploaded Rev March 2022
2. Person Clearance Screen Rev March 2022
3. Reading Medical Home and OEA Summary Reports Rev April 2022
4. Document Upload, Faxing and User Accounts
5. Multiple Tab and Window Functionality
6. Viewing Inactive Apps and Docs
7. Tip Sheet – Medical Home Selection Changes
8. Tip Sheet – Login Captcha and Two Step Verification
9. Tip Sheet – Change in Coverage End Dates

1. System Administrator User Guide Rev April 2022
2. CEC Supervisor User Guide Rev Oct 2015
3. Read Only User Guide Rev April 2022

1. MHLA Eligibility and Enrollment Training Rev January 2023
   • MHLA Comprehensive Eligibility & One-e-App Webinar Training Video Part 1 and 2 New Feb 2023
   • MHLA Comprehensive Eligibility & One-e-App Webinar Training Video Part 3 New Feb 2023
2. MHLA Eligibility Review Requirements Rev April 2022
3. MHLA Household Composition Rev May 2017
4. Income Calculation Guidelines Rev April 2022
   • MHLA Income Verification
     • MHLA IVF Form (English/Spanish) New Jun 2019
     • MHLA IVF FAQ’s Rev July 2021
   • Employer Statement (English Rev Sep 2014/Spanish Rev Aug 2018)
   • Rental Income Worksheet Rev Jun 2019
   • Affidavit
     • Sample Affidavit (English Rev Jul 2014 /Spanish Rev Jun 2019)
     • Affidavit Completion Guide Rev Sep 2018
     • In-Kind Income
       • In-Kind Income Affidavit Processing Guide
       • In-Kind Income Affidavit (English Rev Jun 2019 /Spanish Rev Sep 2014)
       • In-Kind Levels Chart Rev Aug 2014
   • LAC Profit and Loss Statement (English/Spanish Rev Jul 2018)
   • Self Employment Income Tax Forms Rev Jul 2022

(Adding CP Clinic Staff)

1. OEA User Account Application Rev August 2019
2. OEA Application Required Forms

(Deleting CP Clinic Staff)

1. OEA User Account Deletion Form
2. OEA User Account Deletion Form Example

1. MHLA Renewal Best Practices Webinar Rev Sep 2015
2. MHLA Renewal Toolkit Rev Jun 2016
   • Appendix A – MHLA Renewal Notice-90 Day
   • Appendix B – MHLA Renewal Notice-60 Day
   • Appendix C – MHLA Renewal Notice-30 Day
   • Appendix D – Renewal Calendar
   • Appendix E – OEA Renewal Training Rev May 2019
   • Appendix F- OEA Tip Sheets: Medical Home Summary Report
   • Appendix G – Renewal Call Summary Log
   • Appendix H – Template MHLA Poster (English/Spanish)
   • Appendix I – Renewal Appointment Reminder Checklist (English/Spanish)
   • Appendix J – Sample Renewal Call Script

1. OEA Minimum System Requirements
2. Internet Explorer Web Browser Settings Rev Dec 2018
3. OEA Technical Guide Overview

Health Services Office of Patient Access & Health Services Patient Linkage Process

The MHLA Program Office works closely with Health Services Office of Patient Access (OPA) to streamline the Health Services patient referral process to Community Partners (CPs). The following documents are utilized in this process. Please direct any questions regarding this project to the My Health LA (MHLA) Program Advocates.

New Empanelment Request Form (NERF)

• CP/Health Services Patient Linkage Project Fact Sheet (CP Guidance-not for patients) Updated Oct 2018 – This informational flyer explains the patient referral process of enrolling Health Services patients into MHLA.
• The Primary Care Linkage Form New Jul 2018. – This is the newly revised document that is sent securely to the MHLA CP clinics with the list of Health Services patients to contact for enrollment in MHLA.
• If your clinic is unable to accept a MHLA patient referral for clinical reasons, please download and complete this affidavit (Revised Aug 2016) and return it to the MHLA program office as instructed on the form.

1. Provider Bulletin 12 – Older Adult Expansion (Final)
2. Active Member Lookup Tool
3. Active Member Lookup Tool – Instruction
4. How to Use The Active Member Lookup Tool – 10 Minute Video
5. First Notice (Final) to MHLA Participants (English/Spanish)
6. MHLA Older Adult 50+ Presentation Slides 2/16/22
7. Older Adult Transition FAQ CP’s
8. MHLA/Older Adult 50+ Webinar 3/10/22
9. MHLA/Older Adult 50+ Flyer-English
10. MHLA/Older Adult 50+ Flyer-Spanish
11. MHLA/Older Adult 50+ Flyer-Armenian
12. MHLA/Older Adult 50+ Flyer-Korean
13. MHLA/Older Adult 50+ Flyer-Thai
14. MHLA/Older Adult 50+ Flyer-Cambodian
15. MHLA/Older Adult 50+ Flyer-Chinese
16. MHLA/Older Adult 50+ Flyer-Farsi
17. MHLA/Older Adult 50+ Flyer-Tagalog
18. MHLA/Older Adult 50+ Flyer-Russian
19. MHLA/Older Adult 50+ Flyer-Vietnamese