Home & Community Based Waivers
Missouri Division of Developmental Disabilities Targeted Case Management (TCM), Home and Community Based Waiver Services (HCBS), and Preadmission Screening and Resident Review (PASRR) – Nursing Home Reform are federal programs administered by the Centers for Medicare and Medicaid Services (CMS). Division of Developmental Disabilities Targeted Case Management, Home and Community Based waivers, and Preadmission Screening and Resident Reviews are partly funded through federal dollars.
The Missouri Division of Developmental Disabilities includes a Federal Programs Unit (FPU) that operates these federal programs to ensure all federal regulations and requirements are met. The FPU works closely with the state Medicaid authority – MO HealthNet - regarding implementation of Developmental Disabilities TCM and HCBS Waivers. FPU also partners with the Missouri Department of Health and Senior Services with Preadmission Screening and Resident Review (PASRR) – Nursing Home Reform.
Home & Community Based Waivers
The Missouri Department of Mental Health's Division of Developmental Disabilities (Division of DD) administers four Medicaid Home and Community Based (HCB) Waiver programs for individuals with intellectual and developmental disabilities. The four waivers are the Comprehensive Waiver; Missouri Children with Developmental Disabilities Waiver (MOCDD or Sarah Jian Lopez Waiver) Community Support Waiver and Partnership for Hope. A HCBS Waiver Manual provides additional information regarding services, provider qualifications and other waiver requirements.
Centers for Medicare and Medicaid Services Training for Case Managers - Improving the Quality of Home and Community Based Waiver Services. This training emphasizes the important role of case managers in meeting federal HCBS waiver assurances.
- CMS Corrective Action Completion Letter
- ISL CAP Public Comment Summary
- CMS Corrective Action Letter
- DSS ISL CAP Letter
- DSS ISL CAP Enclosure
- MO ISL Corrective Action Plan Acceptance Letter
- Public Notice
- Phase-In Plan for ISL Standardized Rates
- Service Definition Training Q & A - July 2023
- Service Definition Training Q & A - 10-21-21
- Electronic Visit Verification (EVV) Information
- Medicaid State Plan and DHSS Waivers Training
- Power Point Training on State Plan Services
- State Plan Training Webinar
For additional information please contact your local Regional Office. For specific concerns or issues with MO HealthNet Non-Emergency Medical Transportation (NEMT), please contact: DMHMedicaidNEMT@dmh.mo.gov.
In 2022, the State engaged Mercer to conduct a rate study refresh for Intellectual Disabilities/Developmental Disabilities (ID/DD) 1915(c) waiver services. The main goals of the rate study refresh include:
- Comply with Centers for Medicare and Medicaid Services (CMS) requirements to formally review 1915(c) rates at least once every five years
- Compile and analyze the most current Bureau of Labor Statistics (BLS) market data to inform key cost components such as wages and employee-related expenses (e.g., health insurance, other employee benefits, employee-related taxes, workers’ compensation insurance)
- Conduct targeted analyses on other assumptions that providers request be looked at more closely
Mercer initiated the rate study in April 2022 and completed the analysis and modeling work in mid-December 2022. The State engages with the provider community throughout the rate study process in order to understand your concerns, share updates along the way, and gather your feedback. For the key steps in the rate study, please refer to the graphic below. The 2022 HCBS Rate Study provides a summary of the analysis conducted and outlines the results of the rate study.
- SDS Stakeholder Feedback Template
- SDS Rate Study Stakeholder Meeting Presentation 5.16.24
- SDS Rate Study Stakeholder Meeting Presentation 11.30.2023
- HCBS Rate Study Meeting Presentation 11.10.22
- TCM Rate Study
- 2018 Residential Rate Study
