Federal Programs

Missouri Division of Developmental Disabilities Targeted Case Management (TCM), Home and Community Based Waiver Services (HCBS), and Preadmission Screening and Resident Review (PASRR) – Nursing Home Reform are federal programs administered by the Centers for Medicare and Medicaid Services (CMS).  Division of Developmental Disabilities Targeted Case Management, Home and Community Based waivers, and Preadmission Screening and Resident Reviews are partly funded through federal dollars. 

The Missouri Division of Developmental Disabilities includes a Federal Programs Unit (FPU) that operates these federal programs to ensure all federal regulations and requirements are met.  The FPU works closely with the state Medicaid authority – MO HealthNet- regarding implementation of Developmental Disabilities TCM and HCBS Waivers.  FPU also partners with the Missouri Department of Health and Senior Services with Preadmission Screening and Resident Review (PASRR) – Nursing Home Reform.  Below are descriptions and links for each of these programs.    

Targeted Case Management: 

Missouri Division of DD Targeted Case Management (TCM) is an optional state plan program that assists individuals served by the Division to gain access to needed medical, social, educational and other services.  A MO Division of DD Targeted Case Management Technical AssistanceManual is available for Regional Offices, County Senate Bill 40 Boards And Other Not-For-Profit Agencies.

Other TCM resources are available on the DD internet site under Manuals and Publications.

Home & Community Based Waivers

The Missouri Department of Mental Health's Division of Developmental Disabilities (Division of DD) administers five Medicaid Home and Community Based (HCB) Waiver programs for individuals with mental retardation or other developmental disabilities. The five waivers are the Comprehensive Waiver; Missouri Children with Developmental Disabilities Waiver (MOCDD or Sarah Jian Lopez Waiver) Community Support Waiver; Partnership for Hope; and Autism Waiver. A HCBS Waiver Manual provides additional information regarding services, provider qualifications and other waiver requirements.

http://www.hcbsassurances.org/

Centers for Medicare and Medicaid Services Training for Case Managers - Improving the Quality of Home and Community Based Waiver Services. This training emphasizes the important role of case managers in meeting federal HCBS waiver assurances.

Pre-admission Screening and Resident Review (PASRR) – Nursing Home Reform

Federal law requires that a Medicaid-certified nursing facility (NF) may not admit an applicant with serious mental illness (MI), mental retardation (MR), or a related condition, unless the individual is properly screened, thoroughly evaluated and found to be appropriate for NF placement.  The Preadmission Screening and Resident Review (PASRR) program protects individuals with serious mental illness or mental retardation from inappropriate placement in nursing facilities and ensures that individuals receive all specialized services necessary to meet the individual's unique MI/MR needs. PASRR provides the opportunity to identify alternative community supports.  

Other Resources:

Medicaid State Plan and DHSS Waivers Training

For additional information please contact your local Regional Office.