MCCY/MCAW Program Requirements | Missouri Department of Health and Senior Services

PROGRAM REQUIREMENTS (Effective 7/1/2026)
	MCAW (Medically Complex Adult Waiver)	MCCY (Medically Complex Children and Youth)
	MCAW (Medically Complex Adult Waiver)	PDN & PPEC	PC & LT-SNV	ST-SNV
REQUIRED VISITS *
Initial	1-3 months prior to 21st birthday for current MCCY participants or within 10 business days from referral date for non MCCY referrals over the age of 21	10 business days from referral date	15 business days from referral date	N/A
In-person Visits	Every 6 months	Every 6 months	Annual	N/A
Quarterly Phone Contacts	Every 6 months (alternating with in- person visits)	Every 6 months (alternating with in- person visits)	Not Required	N/A
*These are the minimum required guidelines. In the event of any changes or concerns, more frequent contacts are expected and must be completed as appropriate.
FORMS
CC-1	N/A	Initial & Annual	Initial & Annual	N/A
Privacy Policy Acknowledgment	Initial & Annual	Initial & Annual	Initial & Annual	Mailed
Rights & Responsibilities Acknowledgement	Initial & Annual	Initial & Annual	Initial & Annual	Mailed
Expectations of In-Home Services	Initial & Annual (provided every 6 months - no signature required except for Initial/Annual)	Initial & Annual (provided every 6 months - no signature required except for Initial/Annual)	Initial & Annual	N/A
HIPAA Authorization of Disclosure	(if needed) Initial, Annual & PRN	(if needed) Initial, Annual & PRN	(if needed) Initial, Annual & PRN	N/A
PDN Acceptance	Initial & Annual (MCAW SPECIFIC)	Initial & Annual (MCCY SPECIFIC)	N/A	N/A
Client Choice Statement	Initial & Annual	N/A	N/A	N/A
MCAW Services/Participant Preferences Form	Initial, Annual & when changes are made	N/A	N/A	N/A
ASSESSMENTS
SCA (Service Coordination Assessment)	Prior to Paid Enrollment & Annual	Initial & Annual	Initial & Annual	N/A
PDN Assessment	Initial & Quarterly*	Initial & Quarterly	N/A	N/A
PCA/APC Assessment	Optional	N/A	Initial & Annual	N/A
MCAW Client Assessment	Initial & Annual	N/A	N/A	N/A
MCAW Level of Care Determination	Initial & Annual	N/A	N/A	N/A
*This will occur as an abbreviated assessment once transition to Fusion and interRAI is complete
AUTHORIZATIONS
Confirmation of Verbal Service Authorization	Initial, annual & when changes	Initial, annual & when changes	Initial, annual & when changes	Initial (except for Synagis) & when changes
Prior Authorizations	Initial, every 6 months, when changes	Initial, every 6 months, when changes	Initial, every 6 months, when changes	Initial for up to 6 months
Supplies - Invoice of Cost (from Provider)	Initial, when changes & every 6 months	N/A	N/A	N/A
Plan of Care/485 (from Provider)	Initial & every 62 days	Initial & every 62 days	Initial & every 6 months	Initial & every 62 days
Interim/Verbal/Physician's Order (from Provider)	When changes	When changes	When changes	N/A
Program Manager Change Requests	Initial, when there are any changes, & annual when the authorization exceeds Program limits	When the authorization exceeds Program Limits & annual when the over-limit authorization continues	When the authorization exceeds Program Limits & annual when the over-limit authorization continues	N/A
Letter Containing Appeal Rights	With any decrease, denial or change of requested services	With any decrease, denial or change of requested services	With any decrease, denial or change of requested services	With any decrease, denial or change of requested services