Updated August 25, 2026
eLTSS Person-Centered Service Plan Data Exchange
People with intellectual and developmental disabilities (IDD) often get services from many places at once. Hospitals, doctors, therapists, support coordinators, and Home and Community-Based Services (HCBS) providers may all be part of one person's life. Each of them holds a piece of the picture. The problem is that these systems do not always talk to each other. Important details about a person's needs, goals, and supports may not be available at the moment someone needs them most.
The Missouri Department of Mental Health, Division of Developmental Disabilities (DMH-DDD) serves more than 49,000 Missourians with IDD. Every person served through the Division's HCBS Waivers has a Person-Centered Service Plan (PCSP). For years, those plans were on paper or sat in systems that most doctors and hospitals could not see.
That has changed. Through the Electronic Long-Term Services and Supports (eLTSS) initiative, the Division has worked with Missouri's four Health Information Networks (HINs) to share electronic Person-Centered Service Plans (ePCSPs) safely with providers who are authorized to see them. Missouri is the first state in the nation to do this statewide using the nationally recognized eLTSS data standard. Now the people the Division serves can have their ePCSP on hand when their care team needs it.
Project History
Missouri's eLTSS work grew out of federal innovation programs. These included funding from the Centers for Medicare & Medicaid Services (CMS) and the Leading Edge Acceleration Project (LEAP) in Health Information Technology grant program from the Office of the National Coordinator for Health IT (ONC). Those early efforts let Missouri test whether HCBS information could be shared using HL7® FHIR®, a modern health data standard. The tests confirmed that a high degree of interoperability is possible among health and human service providers.
Missouri has since turned that testing into a lasting, state-funded program. Today the eLTSS exchange runs in production with live data. It is a building block for Missouri's longer-term plan for statewide interoperability, including future connection to ConneXion, the Division's new integrated case management system.
Supporting Whole-Person Care
The goal behind the technology is simple: help every provider see the whole person, not just a diagnosis. When care teams can access the ePCSP, providers can find important information during transitions of care, rely less on paper and phone tag, keep health care and HCBS services connected, and build the person's own goals and preferences into the services they deliver.
For individuals and families, this can mean telling the same story fewer times. For providers, it can mean better information and better decisions. Across the state, it supports safer transitions, more person-centered services, and a better quality of life for people with IDD.
Want to learn more? Email PDSA.Help@dmh.mo.gov.
- The eLTSS PCSP Exchange
The Person-Centered Service Plan
The Person-Centered Service Plan (PCSP) is required for people who receive services through Missouri's Medicaid HCBS waivers. The plan describes what matters most to the person. It covers their goals, their strengths, what they prefer, the risks they face, and the supports they need. Each plan is built together with the person, their family or guardian, their support coordinator, and their care team.
Information Sharing Across the Care Team
Missouri shares this information securely, and only with providers who are authorized to see it. Here is the basic flow:
- An individual works with their support coordinator to create or update the PCSP.
- The plan is saved as an electronic PCSP (ePCSP), ready for secure sharing.
- Missouri's Health Information Networks make the ePCSP available to authorized providers.
- Providers view the ePCSP in a secure HIN portal or inside their own electronic health record (EHR) system.
This helps providers coordinate care, communicate with each other, find key information during a transition, and keep services steady over time. A doctor in an emergency room, a support coordinator planning services, and an HCBS provider in the person's home can all work from the same understanding of the person.
Availability Today
This work is growing over time. A provider can view an ePCSP only if two things are true. First, an electronic plan exists for that person. Second, the provider is connected to a participating Health Information Network. Support coordinators who work for the Division can create ePCSPs today, and access will expand to all support coordinators and targeted case management agencies in the future. Both the number of plans available and the number of connected providers continue to grow.
Providers: Want to see this in your workflow? Email PDSA.Help@dmh.mo.gov and we will connect you with your Health Information Network.
- See It in Action: The eLTSS Demonstration Showcase
On July 22, 2026, Missouri hosted the eLTSS Showcase and Lessons Learned Event in Jefferson City. More than 40 people attended in person and 250 joined online. Attendees included Division staff, targeted case management agencies, home and community-based services providers, federal partners from ONC and CMS, and visitors from five other states who came to learn from Missouri.
The recording includes opening remarks from Division leadership, the full demonstration, and a panel discussion.
Maria Wheeler, the Story at the Center of the Showcase
Maria Wheeler is a fictional young woman with a developmental disability, created for the showcase. The Division used a fictional character on purpose, so that a representative story could be told without sharing any real person's health information.
Over the course of a single week, Maria’s story moves through seven points of care:
- Maria begins to feel unwell at work and her Health Home nurse helps her take next steps.
- She has a telehealth visit with an urgent care provider.
- She goes to the hospital emergency department.
- A medical social worker plans her discharge home.
- She works with her support coordinator to update her plan to add new services.
- A new HCBS provider begins working with her on meal planning.
- Her primary care doctor follows up.
Missouri providers narrated each touchpoint using their own real systems. At every step, someone on Maria's care team could view her ePCSP and confirm that the care she was receiving met her needs. The demonstration showed that when everyone supporting Maria can see the ePCSP, she is more empowered and her supports and care become safer, less stressful, and more effective.
The Panel Discussion
After the demonstration, a panel explored what real-time access to person-centered information means in day-to-day work. The conversation brought together four perspectives:
- a parent and guardian, on what it takes to advocate for someone when you cannot be in the room
- a support coordinator, on how plans are built with the person and what changes when care teams are aligned
- an HCBS provider partner, on removing friction from daily work and spending less time chasing down information, and
- a clinical and health information network partner, on what happens when providers outside the HCBS system finally have context about a person walking through their doors.
The panel focused on trust, transparency, and workflow change, connecting the technical work of interoperability to the lived experience of individuals, families, and providers.
Federal and state partners: For the details on the demonstration, email PDSA.Help@dmh.mo.gov.
- Technical Foundation
This section describes how Missouri built the exchange. It is written for health IT professionals, vendors, and federal partners, but anyone curious is welcome to read more below.
The PCSP Application
The PCSP Application is the tool State Support Coordinators use to create ePCSPs. It captures the plan digitally and converts it into the standard electronic format needed for exchange, saving the ePCSP on Missouri’s FHIR server. The PCSP Application is an interim tool. Its functionality will move into ConneXion as Missouri's technology platform continues to evolve.
The eLTSS Standard
Missouri's eLTSS initiative is the first statewide production implementation of the HL7® FHIR® eLTSS Implementation Guide. ePCSPs are exchanged as FHIR R4 resources through four Health Information Networks.
Using a national standard means:
- Missouri's work lines up with national interoperability priorities.
- ePCSP information is portable and can travel with the person.
- Missouri's systems can grow and change over time with lower incremental effort.
A Connected Statewide Network
The eLTSS exchange runs on Missouri's existing Health Information Exchange ecosystem. Each of Missouri's four HINs maintains its independence while aligning on shared standards and governance, demonstrating that a federated model can deliver one statewide exchange. The Division is also expanding that ecosystem through the HCBS Provider HIE Onboarding Program, which helps more HCBS providers connect to a Health Information Network and access clinical and care coordination information.
Security and Privacy
ePCSP information is protected by strict privacy and security rules. Only authorized users can see ePCSP data. All exchange activity follows state and federal requirements, and access controls are built into the workflow itself.
Standards developers, vendors, and federal partners: For use case, implementation details, or questions, email PDSA.Help@dmh.mo.gov.
- Our Statewide Partners
Missouri's eLTSS initiative brings together public, private, and nonprofit organizations. Together they show how standards-based interoperability can improve care for people with IDD.
State Leadership
- Missouri Department of Mental Health, Division of Developmental Disabilities, which provides program leadership and oversight.
- Missouri Office of Administration, Information Technology Services Division (OA-ITSD), which supports enterprise technology and infrastructure.
- Missouri Department of Social Services, MO HealthNet Division, which helps coordinate Missouri’s Health Information Exchange ecosystem.
Health Information Networks
Missouri's Health Information Networks provide the technical capacity and operational expertise to move eLTSS data securely across the state:
- Show-Me Health Information Network (SHINE), a KONZA Health partner
Pioneering Provider Partners and Technical Vendors
- Boone Health
- Easterseals Midwest
- Dr. Joyce Johnson
- Saint Luke’s BJC
- SETWorks
- Sisters Supportive Living
- Skillset
- StationMD
- University of Missouri, Department of Biomedical Informatics, Biostatistics and Medical Epidemiology (BBME)
Technical and Strategic Partners
- Elevations Consultation
Contact
Have a question about the eLTSS initiative? We would like to hear from you.
- Individuals, families, and guardians: Learn what this means for your plan and your care team.
- HCBS and clinical providers: Find out how to access ePCSP information through your Health Information Network.
- Federal and state partners, researchers, and vendors: Request more details on the technical implementation, use case, or lessons learned.
Email PDSA.Help@dmh.mo.gov