Memorandum for Home and Community-Base Services Staff and Stakeholders

DATE: January 20, 2026

FROM: Veronica Jameson, Bureau Chief
Bureau of Policy and Quality Enhancements

SUBJECT: HCBS Policy Updates to the ILW, SFCW and BIW

3.55 Independent Living Waiver

Updates include:

  • Formatting of sections for flow and consistency with other policies
  • Waiver year updated to July 1 through June 30 of the following year to be consistent with all waivers
3.60 Structured Family Caregiving Waiver

Updates include:

  • Formatting of sections for flow and consistency with other policies
  • Eligibility Section – language updated to say “licensed healthcare professional” instead of “physician licensed in the State of Missouri“ as they can be licensed in other states
  • Clarified who may be a caregiver
  • Process Section - diagnosis can be confirmed by “licensed health care professional”, removed “physician” to align with the Eligibility section
4.35.4 Brain Injury Waiver Coordination

Updates include:

  • Formatting of sections for flow and consistency with other policies
  • Reassessments are conducted at least once annually instead of twice a year
  • Waiver year updated to July 1 through June 30 of the following year to be consistent with all waivers

The revised policies have been posted in the HCBS Policy Manual.

Questions should be directed to the Bureau of Policy and Quality Enhancements via email at LTSS@health.mo.gov.

Unless otherwise noted, the policy revisions are effective upon receipt.