Home and Community Based Services Manual8.15 Provider Complaint Process Print Table of Contents Toggle submenu 1.00 Introduction Legal Authority Helpful Links Toggle submenu 1.05 Abbreviations State and Federal Entities Medical Other 1.15 Code of Ethics 1.20 Final Rule Medicaid HCBS Toggle submenu 1.25 Electronic Visit Verification Requirement Policy Manual Index Toggle submenu 2.0 Medicaid Eligibility Special Circumstances 2.0 Appendix 1 Missouri's Medicaid Program 2.00 Appendix 2 Medicaid Income Information 2.00 Appendix 3 Medical Eligibility (ME) Category Chart Toggle submenu 3.0 Available Home and Community Based Services Toggle submenu 3.05 Basic Personal Care – State Plan (Agency Model) Tasks 3.10 Advanced Personal Care - State Plan (Agency Model) 3.15 Authorized Nurse Visits – State Plan (Agency Model) 3.20 RCF/ALF Personal Care – State Plan (Agency Model) Toggle submenu 3.25 Personal Care Assistance – State Plan (Consumer-directed Model) Self Direction Determination Restrictions and Limitations Authorization Tasks Calculating Essential Transportation Toggle submenu 3.25 Appendix 1 Consumer Directed Services Tax Information Overview 3.31 Adult Day Care Waiver 3.35 Chore (Aged and Disabled Waiver) 3.40 Home Delivered Meals (Aged and Disabled Waiver) 3.45 Homemaker (Aged and Disabled Waiver) 3.5 Respite Care (Aged and Disabled Waiver) 3.51 Adult Day Care (Aged and Disabled Waiver) 3.55 Independent Living Waiver 3.60 Structured Family Caregiving Waiver 3.70 Social Services Block Grant/general Revenue Protective Services Participants 3.00 Appendix 1 Services Units and Rates 3.00 Appendix 2 HCBS Cost Maximums 3.55 Appendix 2 Waiting List Notice for Ilw Services Toggle submenu 4.00 Home and Community Based Services Process Introduction 4.05 Intake Process 4.10 Explanation of Level of Care Determination 4.15 Assessment Process 4.20 Person Centered Care Planning and Maintenance 4.25 Provider Reassessment Process 4.30 Case Record Documentation 4.35 Service Coordination 4.35.1 Department of Mental Health Service Coordination 4.35.2 Healthy Children and Youth Service Coordination 4.35.3 HCBS and PACE Coordination 4.35.4 Brain Injury Waiver Service Coordination 4.40 Case Closure 4.00 Appendix 1 Person Centered Care Planning Collateral Contacts 4.00 Appendix 2 Participant Choice Statement Instructions 4.00 Appendix 2d Agency Model Rights and Responsibilities 4.00 Appendix 2e Consumer Directed Services Rights and Responsibilities 4.00 Appendix 2f Residential Care Facilities/assisted Living Facilities Rights and Responsibilities 4.00 Appendix 2g Structured Family Caregiving Waiver Rights and Responsibilities 4.00 Appendix 3 In-Home Services Worksheet 4.00 Appendix 4 Worksheet for Consumer Directed Services 4.00 Appendix 5 Physician Notification of Care Plan 4.00 Appendix 6 Department of Mental Health Customer Management, Outcomes, and Reporting (CIMOR) 4.00 Appendix 7 Department of Mental Health, Division of Developmental Disabilities Contact Information 4.00 Appendix 8 Slums 4.00 Appendix 9 Community Options Information 4.00 Appendix 10 Instructions for Self-Direction Assessment Questions 4.00 Appendix 11 Contact Form Instruction 4.00 Appendix 12 Communication: Reason for Contact 4.00 Appendix 13 Healthcare Proffessional Inquiry 4.00 Appendix 15 Healthcare Information Request Form 4.00 Appendix 16 Structured Family Caregiving Waiver Diagnosis Verification Form Toggle submenu 5.00 Adverse Actions 5.00 Appendix 1 Legal References for Adverse Action 5.00 Appendix 3 Adverse Action Notice 5.00 Appendix 4 Adverse Action Notice 5.00 Appendix 4 Application for the State Hearing 5.00 Appendix 5 Reversal of Adverse Action Notice 5.00 Appendix 6 Notice of Closure Toggle submenu 6.00 Appeal and Hearing Process 6.00 Appendix 1 Department of Social Services, Division of Legal Services Regional Offices 6.00 Appendix 2 Home and Community Based Services Witness Information 6.00 Appendix 3 Qualifying Witness Statement 6.00, Appendix 8 Agency Witness List Toggle submenu 7.00 Show-Me Home 7.00 Appendix 1 Show Me Home Services Specialist 7.00 Appendix 6 SMH/MFP Approval Notice 7.00 Appendix 7 Ombudsman SMH/MFP Referral Instructions Toggle submenu 8.00 Abuse, Neglect and Exploitation 8.00 Appendix 1 Abuse, Neglect and Exploitation Indicators 8.00 Appendix 2 Abuse, Neglect and Exploitation Alleged Perpetrator Indicator List 8.05 Participant Case Records 8.15 Provider Complaint Process 8.00 Appendix 4 General Health Evaluation & Level of Care Recommendation Instructions 8.00, Appendix 9 Person Centered Care Plan Form Toggle submenu 9.00 Confidentiality Requirements 9.00 Appendix 5 Acknowledgement Form Instructions 9.00 Appendix 6, Authorization For Disclosure Of Consumer Medical/Health Information Toggle submenu Policy Clarification Questions Advanced Personal Care Agency Model Personal Care (In-Home Services) Assessment / Reassessment Assisted Living Facility/Residential Care Facility Personal Care Authorized Nurse Visits Consumer Directed Services Consumer Directed Services/Transportation (Essential Transportation) General Overview Respite Care Shared Living Spaces Structured Family Caregiving Waiver (SFCW) Task Chart On this page Book traversal links for 20846 ‹ 8.05 Participant Case Records Up 8.00 Appendix 4 General Health Evaluation & Level of Care Recommendation Instructions ›
