REMINDER:  Public Comments are Due Sunday, Aug. 13, 2023 for the
MO HealthNet Home and Community Based Services (HCBS) Waiver Updates

The Division of Developmental Disabilities (DSS) is making some changes to their waiver definitions. DSS must give everyone a period of time to make comments about these changes. This document has the proposed changes. States must get public input when they develop a waiver or make important changes to waivers.

If you would like to make a comment, you can do this by writing or emailing the Division:

• MO HealthNet will accept written public comments until Sunday, August 13, 2023.
• Comments may be mailed to:
  • MO HealthNet Division P.O. Box 6500 Jefferson City, MO 65102-6500 Attn: MO HealthNet
• Or, comments may be emailed to: Ask.MHD@dss.mo.gov

The primary purpose of the changes is to update service terms.

The goals of the waiver program are:

1. To support individuals with intellectual and developmental disabilities (I/DD) to live independently in the community.
2. Provide many kinds of services that promote community living and integration. This includes providing self-directed options and traditional agency-based services.
3. Maintain and improve community based care to keep people from having to go to an institution or residential care.

Waiver applications have many parts. These are “Appendices.” You can read the full document here. The changes presented impact only a few of these Appendices:

• Appendix B
• Appendix C
• Appendix I
• Appendix J

The proposed changes will:

1. Increase the number of people served by the Comprehensive and Community Support Waivers. This increase will match the increase in funding available.
   
2. Remove temporary FMAP Funding Language.  FMAP Stands for “Federal Medical Assistance Percentage.”
   • Money came to states as part of the American Rescue Plan (sometimes referred to as ARPA funding). ARPA funding was temporary. ARPA funding made Missouri’s FMAP rate higher and we received more money. This updates the waiver language by removing this. Since the money was temporary, it doesn’t need to be in the waiver definitions.
     
3. Update Group Home Service. This will make it clear that the oversight is separate and not included in the group home service rate. This will not result in an increase or decrease in funding. This only changes how to track it.
   
4. Allow more money for people who are transitioning to a private home from a provider. They could be transitioning from an institution or another provider-operated living arrangement.
   • This changes the amount of money from $3,000 to $3,900. This is an increase of $900. This is the amount for a person over their lifetime.
     
5. Update the definition for remote supports to include the training period. This means that as staff learn how to use remote supports, they will be reimbursed.
   
6. Update the ISL Transportation Rate from a negotiated monthly rate to a standardized per mile rate. This is the rate the providers are reimbursed for transportation costs. Providers that currently receive below the standardized rate of $0.83/mile, may decide to receive this rate. If providers currently receive more than $0.83/mile as part of their negotiated rate, they will be able to keep it.
   
7. Update the Self-Directed Service Rate from always matching the agency service rate to the current rates in effect for July 1, 2022 to June 30, 2023.
   • This will “un-link” self-directed service (SDS) rates from agency service rates. Right now, if agency rates increase, SDS rates will increase to the same amount. If agency rates increase, SDS rates are no longer required to increase. If approved SDS rates will not increase this year.

We encourage everyone who has an interest to submit their comments on these changes.

Did you find this information helpful? After you submit a public comment, we would love to know if this was helpful or beneficial to you. Please take a moment to share your advocacy summary with us.