Home and Community Based Services - Provider Information (Partners & Providers) | Missouri Department of Health and Senior Services

Home and Community-Based Services (HCBS) are intended to help participants who need nursing facility-level of care to stay in their least restrictive environment. Medicaid funded HCBS are available through either State Plan services or 1915(c) Home and Community-Based Waiver.

State Plan Services

DSDS administers state plan services under the authority of TXIX of the Social Security Act. There are two models of state plan services: the Agency Model and the Consumer-Directed Services Model.

Agency Model

The Agency Model for In-Home Services (IHS) refers to a system in which a home care agency provides and employs the caregivers and handles the administrative functions related to service delivery.

Basic Personal Care
- Basic Personal Care (PC) refers to hands-on tasks that assist a person with everyday activities that they are unable to perform on their own. Common tasks include bathing, dressing, toileting, grooming, mobility support, and household chores.
Advanced Personal Care
- Advanced Personal Care (APC) addresses more complex medical needs involving devices and procedures for altered body functions. Examples include assistance with a transfer device, catheter maintenance, and ostomy hygiene.
Authorized Nurse Visits
- Authorized Nurse Visits (RN) are maintenance or preventive services provided to participants with stable, chronic conditions. They are generally not intended for treating acute health issues and are limited to once per week. Examples include skin monitoring and medication setup.
Residential Care/Assisted Living Facility Personal Care [NEEDS LINK]
- Participants of Residential Care Facilities (RCF) or Assisted Living Facilities (ALF) may be authorized for services to assist with personal care and nursing needs. These services are authorized for eligible residents when their needs exceed the facility's basic obligations as outlined in licensure standards. The services available include Personal Care (PC) services, Advanced Personal Care (APC) services, and Authorized Nurse Visits.

Consumer Directed Services

The Consumer Directed Services (CDS) program allows the participant to hire and manage their own caregivers, including family members, to assist with ADLs. This model shifts control from traditional home care agencies to the participant receiving care. CDS is available to participants with a physical disability who can direct their own care and live independently.

Consumer Directed Personal Care Assistance
- CDS Personal Care provides both basic and advanced personal care related tasks to participants with physical disabilities. CDS also supports transportation and essential correspondence needs.

Waiver Services

DSDS oversees six (6) HCBS waivers, providing a wider range of services than the Medicaid state plan. These waivers have their own eligibility criteria, which differ from the state plan. A participant can only enroll in one waiver at a time, and because of enrollment limits, some waivers might have a waiting list.

Participant Rights and Responsibilities

As someone receiving HCBS, you have the right to receive services in a person-centered way that supports community participation, independence, and choice in your daily life and services.

You also have responsibilities, which include following the approved person-centered care plan, engaging respectfully with providers, reporting any harm, and ensuring services are not used for other purposes or provided when you are not home.

At the time of the initial assessment and the annual reassessment, the Rights and Responsibilities will be reviewed with you. Depending on the services you receive, there may be more than one type of Rights and Responsibilities.

You can review the Rights and Responsibilities for each program below:

HCBS Services

Topic Menu: Home and Community Based Services - Provider Information (Partners & Providers)