I Don’t Have Services; How do I Apply?

I Don’t Have Services; How do I Apply?

If you are not receiving help from the HCBS program, the first step is to request an Initial Referral. You can do this in two ways:

  • Online: Fill out the HCBS Referral form on the computer
  • By Phone: Call 1-866-835-3505. 

If the minimum eligibility requirements are met at the time of the referral, the referral will be sent to the assessment team who will reach out to schedule a face-to-face Initial assessment. The assessment will evaluate your level of care and determine your unmet needs or what support is needed.

Preparing for an Assessment – What to Expect

Review the following information about what to expect during the face-to-face home visit and how to prepare.

A copy of the ‘Preparing for an Assessment’ document can also be downloaded.

Prepare to Communicate with Assessor:

  • A HCBS Assessor will call to schedule a face-to-face assessment with you. The purpose of the HCBS program is to provide support for you to stay at home or where you choose to live.
  • In order for Medicaid to pay for HCBS, your care needs have to be equal to nursing home care. Our assessment will determine if your care needs meet the requirement for Medicaid to pay for services in your home.
  • We will attempt to contact you one time. Please ensure your phone can receive messages and return your HCBS assessors call. If you do not answer, a message will be left or a letter sent, and you will have 10 days to return our call. If you do not respond within the 10 days, the referral for services will be closed.
  • We must verify we are speaking with you. Be prepared to verify your:
    • MO HealthNet (Medicaid) number
    • Date of Birth
    • Social Security Number
    • Address
    • Phone Number

Prepare for the Assessment

The HCBS Assessor will use a set of questions to determine if you are eligible for HCBS. Below are just a few questions you should be prepared to answer:

  • Do you want Agency Model or Consumer Directed Services?
    • Agency Model: Provider agency selects, hires, trains & supervises your caregiver
    • Consumer Directed: You select, hire, train & supervise your caregiver
  • What specific help and support do you need?
    • How often do you need help?
    • How much time does each task take to complete?
  • Do you have a guardian or Durable Power of Attorney?
    • Have a copy of guardianship or power of attorney paperwork (if applicable)
  • Who will provide back-up support to you when your caregiver is not available?
    • You must provide a back-up plan that includes:
      • Name(s)
      • Relationship(s)
      • Phone Number(s)
      • Task(s) the back-up person(s) can support you with
  • What provider would you like to use?
    • Full business name and phone number
    • The name of the person you have been in contact with from the agency you wish to transfer your services to.
    • A list of providers in your area can be found by utilizing the HCBS Fusion Provider Search Database
  • Who are your medical and healthcare providers?
    • Contact information available for key medical or mental health professionals such as:
      • Primary care physician
      • Social worker
      • Therapist
      • Hospice
      • Home health, etc.
  • Who will provide back-up support to you when your caregiver is not available?
    • You must provide a back-up plan that includes:
      • Name(s)
      • Relationship(s)
      • Phone Number(s)
      • Task(s) the back-up person(s) can support you with

About Home & Community Based Services

  • Certain services have limits on cost, age, ability to self-direct, and other items. We will work with you to figure out what services you qualify for and build your care plan around what Medicaid and the HCBS Program allows.
  • HCBS services are based on your current needs.  HCBS cannot provide help with things you do not need today.
  • HCBS is not a total care or 24/7 care program. HCBS can provide extra help to add to the support system you currently have.
  • You may have anyone of your choosing present during the assessment.

Ensuring the safety of our participants and team members is top priority for us. Please secure all pets, weapons, or potential hazards before the HCBS Assessor enters your home setting.