Table of Contents

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  1.00 Introduction
  • Legal Authority
  • HCBS Waivers
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    1.05 Abbreviations
    • State and Federal Entities
    • Medical
    • Other Abbreviations
  • 1.15 Code of Ethics
  • 1.20 Final Rule Medicaid HCBS
  • 1.25 Electronic Visit Verification
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  2.00 Medicaid Eligibility
  • 2.00 Appendix 1 Missouri's Medicaid Program
  • 2.00 Appendix 2 Medicaid Income Information
  • 2.00 Appendix 3 Medical Eligibility (ME) Category Chart
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  3.00 Available Home and Community Based Services
  • 3.05 Basic Personal Care – State Plan (Agency Model)
  • 3.10 Advanced Personal Care - State Plan (Agency Model)
  • 3.15 Authorized Nurse Visits – State Plan (Agency Model)
  • 3.20 RCF/ALF Personal Care – State Plan (Agency Model)
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    3.25 Personal Care Assistance – State Plan (Consumer-Directed Service Model)
    • Personal Care Assistance - State Plan (Consumer-Directed Services Model)
  • 3.31 Adult Day Care Waiver
  • 3.35 Chore (Aged and Disabled Waiver)
  • 3.40 Home Delivered Meals (Aged and Disabled Waiver)
  • 3.45 Homemaker (Aged and Disabled Waiver)
  • 3.50 Respite Care (Aged and Disabled Waiver)
  • 3.51 Adult Day Care (Aged and Disabled Waiver)
  • 3.55 Independent Living Waiver
  • 3.60 Structured Family Caregiving Waiver
  • 3.70 Social Services Block Grant/General Revenue Protective Services Participants
  • 3.00 Appendix 1 Services Units and Rates
  • 3.00 Appendix 2 HCBS Cost Maximums
  • 3.25 Appendix 1 Consumer Directed Services Tax Information
  • 3.55 Appendix 2 Waiting List Notice for ILW Services Instructions and Form
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  4.00 Home and Community Based Services Process Introduction
  • 4.05 Intake Process
  • 4.10 Explanation of Level of Care Determination
  • 4.15 Assessment Process
  • 4.20 Person Centered Care Planning and Maintenance
  • 4.25 Provider Reassessment Process
  • 4.30 Case Record Documentation
  • 4.35 Service Coordination
  • 4.35.1 Department of Mental Health Service Coordination
  • 4.35.2 Medically Complex Children and Youth
  • 4.35.3 HCBS and PACE Coordination
  • 4.35.4 Brain Injury Waiver Service Coordination
  • 4.40 Case Closure
  • 4.00 Appendix 1 Person Centered Care Planning Collateral Contacts
  • 4.00 Appendix 2 Participant Choice Statement Instructions and Form
  • 4.00 Appendix 2c Adult Day Care Rights and Responsibilities
  • 4.00 Appendix 2d Agency Model Rights and Responsibilities
  • 4.00 Appendix 2e Consumer Directed Services Rights and Responsibilities
  • 4.00 Appendix 2f Residential Care Facilities/Assisted Living Facilities Rights and Responsibilities
  • 4.00 Appendix 2g Structured Family Caregiving Waiver Rights and Responsibilities
  • 4.00 Appendix 3 In-Home Services Worksheet Instructions and Form
  • 4.00 Appendix 4 Worksheet for Consumer Directed Services Instructions and Form
  • 4.00 Appendix 5 Physician Notification of Care Plan Instructions
  • 4.00 Appendix 6 Department of Mental Health Customer Management, Outcomes, and Reporting (CIMOR)
  • 4.00 Appendix 7 Department of Mental Health, Division of Developmental Disabilities Contact Information
  • 4.00 Appendix 8 SLUMS Instructions and Form
  • 4.00 Appendix 9 Community Options Information
  • 4.00 Appendix 10 Self-Direction Assessment Questions Instructions and Form
  • 4.00 Appendix 11 Contact Form Instructions
  • 4.00 Appendix 12 Communication: Reason for Contact
  • 4.00 Appendix 13 Healthcare Professional Inquiry
  • 4.00 Appendix 14a
  • 4.00 Appendix 14b
  • 4.00 Appendix 15 Healthcare Information Request Form Instructions
  • 4.00 Appendix 16 Structured Family Caregiving Waiver Diagnosis Verification Form Instructions
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  5.00 Adverse Actions
  • 5.00 Appendix 1 Legal References for Adverse Action
  • 5.00 Appendix 3 Adverse Action Notice Instructions
  • 5.00 Appendix 4 Application for State Hearing Instructions
  • 5.00 Appendix 5 Reversal of Adverse Action Notice Instructions
  • 5.00 Appendix 6 Notice of Closure Instructions
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  6.00 Appeal and Hearing Process
  • 6.00 Appendix 1 Department of Social Services, Division of Legal Services Regional Offices
  • 6.00 Appendix 2 Home and Community Based Services Witness Information
  • 6.00 Appendix 3 Qualifying Witness Statement
  • 6.00 Appendix 6 - CMS Letter
  • 6.00 Appendix 7 - Cover Letter
  • 6.00, Appendix 8 Agency Witness List Instructions
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  7.00 Show-Me Home
  • 7.00 Appendix 1 Show Me Home Services Specialist
  • 7.00 Appendix 6 SMH/MFP Approval Notice
  • 7.00 Appendix 7 Ombudsman SMH/MFP Referral Instructions
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  8.00 Abuse, Neglect and Exploitation
  • 8.00 Appendix 1 Abuse, Neglect and Exploitation Indicators
  • 8.00 Appendix 2 Abuse, Neglect and Exploitation Alleged Perpetrator Indicator List
  • 8.00 appendix 3 - HCBS Referral Form
  • 8.00 Appendix 4 General Health Evaluation & Level of Care Recommendation Instructions/Form
  • 8.00 appendix 5 - Physician Prescription for Personal Care Services
  • 8.00 Appendix 6 - FSD HCB Medicaid Referral
  • 8.00 Appendix 7 - Online Grievance Portal
  • 8.00 Appendix 9 Person Centered Care Plan Instructions and Form
  • 8.05 Participant Case Records
  • 8.15 Grievance Process
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  9.00 Confidentiality Requirements
  • 9.00 Appendix 5 Acknowledgement Instructions
  • 9.00 Appendix 6, Authorization For Disclosure Of Consumer Medical/Health Information Instructions
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  HCBS Policy Clarification Questions
  • Advanced Personal Care
  • Agency Model Personal Care (In-Home Services)
  • Assessment / Reassessment
  • Assisted Living Facility/Residential Care Facility Personal Care
  • Authorized Nurse Visits
  • Consumer Directed Services
  • Consumer Directed Services/Transportation (Essential Transportation)
  • General
  • Respite Care
  • Shared Living Spaces
  • Task Chart