Medicaid Waiver Programs in Missouri

As of January 2022 data, Missouri offers several Medicaid waiver programs, known as Home and Community-Based Services (HCBS) waivers, designed to provide long-term care services to eligible individuals in home and community settings. Here are some key Medicaid waiver programs in Missouri:

1. Aged and Disabled (AD) Waiver: This waiver is for individuals aged 65 and older or those with disabilities. It provides various services to help them remain in their homes or communities instead of nursing homes, including personal care, adult day care, homemaker services, and more.
2. Adult Day Care (ADC) Waiver: This waiver offers continuous care and supervision in a licensed adult day care setting to disabled adults ages 18 through 63 who meet nursing facility level of care. Services include but are not limited to assistance with activities of daily living, planned group activities, food services, observation, skilled nursing services as specified in the plan of care and transportation to and from the adult day care setting. The Department of Health and Senior Services, Division of Senior and Disability Services administers this program.
3. Developmental Disabilities (DD) Waiver: Designed for individuals with intellectual or developmental disabilities, this waiver provides services such as residential supports, day programming, personal care, therapies, and supported employment.
4. Community Support (CS) Waiver: This waiver assists individuals with severe mental illnesses by offering services like case management, psychosocial rehabilitation, therapy, and peer support to help them live in community settings.
5. Independent Living (IL) Waiver is similar to the Consumer-Directed State Plan Personal Care program, requiring the same eligibility criteria be met and offering additional personal assistance services beyond the limitations of the state plan. Additional services available include:
   • environmental accessibility adaptations
   • specialized medical equipment and supplies
   • financial management services
   • case management
6. Brain Injury (BI) Waiver: This waiver is for individuals with traumatic brain injuries and offers services tailored to their specific needs, including therapies, behavioral supports, and assistance with daily living tasks.
7. The Missouri Autism Waiver is a Medicaid waiver program specifically tailored to address the unique needs of individuals with autism. It offers a range of services and supports to enhance the quality of life for individuals with autism and their families. This waiver program is funded through Medicaid and administered by the Missouri Department of Mental Health (DMH). It aims to provide comprehensive and individualized services to eligible individuals with autism, with a focus on promoting their independence and inclusion in the community.
8. The Structured Family Caregiving Waiver (SFCW) was developed to provide a comprehensive and cost-effective Home and Community-Based Service (HCBS) option for individuals ages 21 and older diagnosed with Alzheimer’s or a related disorder who wish to live at home in the community and would otherwise require institutionalization in a nursing facility. The Department of Health and Senior Services, Division of Senior and Disability Services administers this program.
9. The Medically Fragile Adult Waiver offers services to individuals who have serious and complex medical needs and are no longer eligible for services under the Healthy Children and Youth program. To be eligible, an individual must be age 21 or older and assessed as requiring placement in an ICF/MR absent these services. The services available include:
   • attendant care
   • private duty nursing
   • specialized medical supplies
10. The Missouri Children with Developmental Disabilities Waiver (MOCDD), also known as the Sarah Lopez Waiver, grants Medicaid eligibility to those children who would be determined eligible for MO HealthNet if they were to reside in an institution, but whose families have chosen to have the child remain home. The MOCDD waiver permits the state to view only the child’s income when making the eligibility determination. Some services provided through the MOCDD waiver include:
    • Day Habilitation
    • Respite
    • Personal Assistant
    • Applied Behavior Analysis (ABA)

    • Crisis Intervention
    • Specialized Medical Equipment and Supplies (Adaptive Equipment)
    • Transportation

Each waiver program in Missouri has its own eligibility criteria, services covered, and enrollment process. Services covered can include personal care, case management, therapies, home modifications, and more.

For detailed information on these and other Medicaid waiver programs in Missouri, including eligibility requirements and how to apply, contact the Missouri Department of Social Services or the Division of Senior and Disability Services. Additionally, consulting with a Medicaid specialist or an elder law attorney familiar with Missouri’s Medicaid services can provide specific guidance regarding these programs.