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 intellectual or other developmental disabilities. The five waivers are the Comprehensive Waiver, Missouri Children with Developmental Disabilities Waiver (MOCDD or Sarah Jian Lopez Waiver); Support Waiver, Partnership for Hope, and Autism Waiver.

Authority for the Division of DD waivers is the result of a federal law enacted by Congress in 1981 that added a new section to the Social Security Act in 1915(c). Under Home and Community-based waivers, a state may use Medicaid funding for home and community-based services provided only to a target group of people who have intellectual and developmental disabilities and whose care needs would otherwise require services in an institution. Federal law also allows a state to target services by geographic region. The Division of DD uses general revenue funds and local county dollars to match federal dollars to pay for HCB waiver services.

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