The 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 TCM, HCBS waivers, and PASRR 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 PASRR – Nursing Home Reform. Below are descriptions and links for each of these programs.

Targeted Case Management:

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

CMS 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 PASRR program protects individuals with serious mental illness or intellectual/developmental disability (I/DD) from inappropriate placement in nursing facilities and ensures that individuals receive all specialized services necessary to meet the individual's unique MI/DD needs. PASRR provides the opportunity to identify alternative community supports.

Other Useful Information

Other Resources:

For additional information please contact your local Regional Office.