The Missouri Division of Developmental Disabilities was established in 1974 to support the unique needs of individuals, family members and caregivers who experience a developmental disability (DD). The Division understands that individuals and those who support them, have diverse strengths, abilities, needs and challenges.
Individuals and families identify that they face greater challenges in their attempt to navigate day-to-day life. They state the need for:
- Relevant Information;
- Resources;
- Access to valuable supports and services, as well as;
- The opportunity to share their life experiences with others in similar situations to ensure long term success.
The services and supports provided by the Division are centered on empowering individuals and families to:
- Experience quality and meaningful lives;
- Become valued members of their communities where they:
- Live
- Work
- Play
- Learn
- And pursue their life goals.
- What is a developmental disability?
A developmental disability is:
- A disability which is attributable to an intellectual disability, cerebral palsy, epilepsy, head injury, autism, or a learning disability related to brain dysfunction, or any other mental or physical impairment;
- Occurs prior to the age of 22;
- The disabling condition is likely to continue indefinitely;
- Results in Substantial Functional Limitations in 2 of the six areas listed below:
- Self-Care
- Receptive/ Expressive Language
- Learning
- Mobility
- Self-Direction
- Capacity for Independent Living/ Economic Self-Sufficiency;
- Requires some level of habilitative training. Habilitative means skill development that assists the individual learning to become more independent.
- How do I access Division of DD Services
Navigating the Division of DD System
Referral & Application Process
Obtaining Division of Developmental Disabilities services begins by contacting and making a referral to the local Regional Office for the county the applying individual resides in. Anyone can make a referral on behalf of an interested individual. You can view a map of Regional Offices to locate your office by clicking on Map of Regional Offices.
- After a referral has been made by phone, fax, email, mail, or in person - a member of the Intake Team will conduct an initial interview. The Intake Team will attempt to contact the individual or responsible person no later than one business day after the referral was received. The interview can be completed on the phone, in person, or by email if requested. The Intake Specialist will gather basic information needed to fill out the application and gather documents to determine eligibility. This information may include:
- Full legal name
- Date of birth
- Social security number
- Physical address and mailing address
- Phone number and email address (if applicable)
- MO HealthNet (Medicaid) status
- Diagnosed intellectual and/or developmental disability
- Diagnosing physician and/or entity
- Special communication needs
- Responsible person information (name, relationship, contact information)
- Information gathered during the initial interview is used by the Intake Team to fill out an application. The filled-in application packet will be provided to the individual and/or responsible person by mail, email, or in person. The application packet will consist of:
- Information about the determination process including details about different steps that will occur
- Rights of Department of Mental Health Consumers
- Department of Mental Health Notice of Privacy Practices
- Application
- Application Packet Acknowledgement & Consent (sign and return)
- Notice of Privacy Practices Acknowledge & Consent (sign and return)
- Authorization for Disclosure of Consumer Medical/Health Information - Release of Information (sign and return)
- The Intake Team will mark where signatures are needed and will note additional information or documents that may be required.
Note: if the individual has a legal guardian or court ordered custody, all legal documents will need to be provided with the signed application.
- Once the application documents have been reviewed and signed, they will need to be returned to the appropriate Regional Office. This can be done by mail, email, fax, or in person.
- The application documents will be reviewed by the Intake Team to make sure everything is complete. Once the application is determined to be complete, the Determination Process will begin.
Determination Process
The eligibility process may look differently for everyone based upon documents submitted with the application and previous Division of Developmental Disabilities services.
- Record Verification: The first step of the Determination Process is for the Intake Team to verify that the applying individual has a diagnosis related to an intellectual and/or developmental disability. This is done by collecting medical, psychological, educational, and/or other relevant records. These can be provided directly by the applying individual or responsible person or the Intake Team can request these records directly by using the signed Authorization for Disclosure of Consumer Medical/Health Information – Release of Information that was submitted with the application packet contents.
All records received are reviewed by the Intake Team. Once records that “substantiate” or confirm a qualifying intellectual and/or developmental disability are received, the applying individual will move the second step of the Determination Process.
Note: The Division of Developmental Disabilities does not provide any diagnostic testing or confirmation of conditions. All applying individuals must already have testing completed prior to applying for services.
- Assessment Review/Completion: After a qualifying condition has been confirmed, the Intake Team will schedule a Missouri Adaptive Ability Scale (MAAS) that is administered by the Division of Developmental Disabilities’ Assessment Team. The MAAS is an adaptive assessment which is used to verify that the applying individual meets the substantial functional limitation requirements. A MAAS may not have to be administered if an alternative adaptive assessment was received during the Record Verification step. The alternative adaptive assessment must be valid and meet substantial functional limitation requirements. An assessment is considered valid if it is less than three years old, psychometrically sound, and norm referenced.
Once a valid adaptive assessment has been reviewed or a MAAS has been completed, the applying individual will move the third and final step of the Determination Process.
- Determination & Referral: If an individual is determined eligible, the Intake Team completes an Eligibility Notification. This is a document that explains how the applying individual was found eligible to be served through the Division of Developmental Disabilities, what service they qualify for, and where they are being referred for services. This document is provided to the individual and/or responsible person via mail or email. When an individual is found eligible to be served through the Division of Developmental Disabilities, the Intake Team will initiate a service referral within three business days. This referral is based upon the individual’s MO HealthNet (Medicaid) status and county of residence.
Note: Medicaid Waiver eligibility is not determined during this process. An individual may be determined eligible to be served through the Division of Developmental Disabilities but may not meet Medicaid Waiver eligibility requirements. After an individual is determined eligible to be served through the Division, a Support Coordinator can discuss specific Waiver Program requirements and services the individual may be eligible for.
If an individual is determined ineligible to be served through the division, the Intake Team completes a Notice of Denial and will notify the individual and/or responsible person within one business day. The Notice of Denial explains how the applying individual was found ineligible and provides Appeal Rights with contact information to schedule an appeal. An appeal can be requested within 30 calendar days from the date of the denial.
The individual and/or responsible person can contact the Intake Team at any point in the process. The Intake Team is available to assist with application completion, answering questions, providing status and process updates, and offering additional resources.
- After a referral has been made by phone, fax, email, mail, or in person - a member of the Intake Team will conduct an initial interview. The Intake Team will attempt to contact the individual or responsible person no later than one business day after the referral was received. The interview can be completed on the phone, in person, or by email if requested. The Intake Specialist will gather basic information needed to fill out the application and gather documents to determine eligibility. This information may include:
- What types of Division services and supports are available?
Resource & Referral/Information Specialist System (R&R)
Individuals who qualify for services who are not currently enrolled in Medicaid, and who do not reside in a county with an intent to serve individuals without Medicaid, will be assigned to the Resource & Referral/Information Specialist (R&R) system. On average, R&R covers over 30 counties across the state. Once assigned, R&R staff work with individuals who need assistance with Medicaid applications, resolving Medicaid issues, help with identifying and accessing resources, make referrals to other agencies, assistance with applications, and more depending on individual needs. Assignment to the Resource & Referral/Information Specialist system allows individuals without Medicaid to maintain an open Episode of Care (EOC) within the Division of DD services, which allows them to continue to access other services, receive assistance when needed, and easily transition to Support Coordination if/when Medicaid is activated. There are two ways to contact the Resource & Referral/Information Specialist system, by email at Information.Specialist@dmh.mo.gov and by phone at 1-800-241-2741.
Support Coordination/ Case Management
Individuals with active Medicaid are eligible for support coordination in all counties. Some counties have agreed to serve individuals who do not have Medicaid and individuals who reside in those counties may also receive support coordination. Support Coordination means that the Division itself or a contracted Targeted Case Management provider will work with the individual/ responsible party to identify specific needs and goals and a plan will be developed to access any and all available resources to meet those goals. This can be as simple as a yearly face to face meeting, school advocacy or direction on accessing other services within the community. It can also be as involved as accessing funded services offered by the Division through various funding sources.
Purchased Services
Any support beyond Support Coordination is considered a funded direct support service. New requests for funding require that the individual in need has active Medicaid. Missouri works in partnership with the federal government to share the costs of services through participation in Medicaid Waivers. The specific requirements to access such funding can be discussed in greater detail with the assigned Support Coordinator.
There is one exception to this rule. Any individual with an Autism diagnosis has the ability to access specific funding distributed by the five Parent Advisory Councils across the state. This allotment of funding is provided solely by Missouri tax dollars and not in partnership with the Federal Government, which means participating in Medicaid is not a requirement.
- How are services approved?
Following eligibility, the individual, family or guardian meets with a Support Coordinator to develop a plan, called a Person-Centered Service Plan (PCSP). This PCSP includes a description of the individual, the person’s goals and needs, what outcomes are expected to be achieved, and the particular services and funding being requested. This plan is then reviewed at the Regional or Satellite office for approval.
If the Division does not have enough funds to serve everyone who is approved for services, then a Priority of Need process determines who can begin their services and who must wait.
- What other agencies provide services and supports?
Missouri has few restrictions when it comes to accessing services and supports from other state and private agencies. Typically, if the individual qualifies for the service or support, then they can access it regardless of their relationship to other state and private agencies. *See exceptions below. A list of some agencies and services that can be accessed include:
Missouri First Steps - Administered by the Department of Elementary and Secondary Education and serves children 0-3 years old who have a qualifying medical condition or who demonstrate a Half Age Delay in development.
WIC - Administered through the Department of Health and Senior Services, the program provides supplemental food and nutrition education to pregnant women, new mothers and children up to age five. Individuals must be certified in person to receive services. WIC certification and services are offered in 117 agencies across the state, primarily at your local county health department.
Special Healthcare Needs - Administered by the Department of Health and Senior Services, providing service coordination and authorization for medically necessary services for children and medically fragile adults with special health care needs that meet medical and financial eligibility requirements.
Division of Vocational Rehabilitation - Administered by the Department of Elementary and Secondary Education, assisting individuals with various disabling conditions to find employment either through job search assistance or education/ training assistance.
Family Support Division - Administered by the Department of Social Services, providing such programs as MO HealthNet (Medicaid), SNAP, TANF, and others.
Senior and Disability Services - Administered by the Department of Health and Senior Services, providing in-home supports to adults with on-going medical and or physical needs who have active MO HealthNet.
HIPPS - (Health Insurance Premium Payment) Administered by the Department of Social Services. It exists to reimburse the cost of private health insurance premiums for those who are active with the MO HealthNet system. The reimbursement takes place if it is determined to be cost effective. Each case is reviewed on an individual basis.
*Exception to the rule:
Many state agencies have arrangements with the federal government to share the costs of certain services. These are typically referred to as Medicaid Waivers. Regulations state that a Missouri citizen can only access one Medicaid Waiver at a time. This means that if a person is actively receiving Medicaid Waiver services from one state agency, they are not eligible to access Medicaid Waiver services through another state agency.
- Caregiver Stress Resources
- Additional Information
- MAAS Assessment and Scheduling—Key Points for Individuals and Families The Division of Developmental Disabilities has been working on a plan to make the assessment (tests) and eligibility processes better, including scheduling assessments (tests) like the MAAS. Because there has been a lot of information and updates shared about the MAAS and scheduling, the Division has created a plan that captures all of the important items in one document. This plan is called the Assessment Capacity Bridge Plan. It explains the temporary changes that should make a faster process to help individuals and families seeking or currently receiving services.
- Public Administrator Training - This training was developed to assist Public Administrators in navigating supports and services for those with intellectual/developmental disabilities.
- How and Where to Get Help
- Community Living and Accessible Housing
- Quality Assurance Unit
- Consumer Safety
- Acronyms and Abbreviations
- Eligibility Criteria for Services
- Olmstead Information
- Missouri Proclamation of Equal Rights for People with Disabilities as Members of Society
- Supporting Families Resource List
- Pre-admission Screening and Resident Review (PASSR)
Individual and Family Guides
Volunteer & Advocacy Opportunities
- MAAS Assessment and Scheduling—Key Points for Individuals and Families The Division of Developmental Disabilities has been working on a plan to make the assessment (tests) and eligibility processes better, including scheduling assessments (tests) like the MAAS. Because there has been a lot of information and updates shared about the MAAS and scheduling, the Division has created a plan that captures all of the important items in one document. This plan is called the Assessment Capacity Bridge Plan. It explains the temporary changes that should make a faster process to help individuals and families seeking or currently receiving services.
- 988 Suicide & Crisis Lifeline
988 is a three-digit number that offers 24/7 statewide access to crisis services via call, text, or chat. Trained crisis specialists can help individuals experiencing suicidal thoughts, substance use, and/or mental health crisis or any other kind of emotional distress.
For more information, please visit Missouri 988.