Missouri Code of State Regulations › Title 9 - DEPARTMENT OF MENTAL HEALTH › Division 45 - Division of Developmental Disabilities › Chapter 2 - Eligibility for Services › Section 9 CSR 45-2.015 - Prioritizing Access to Funded Services

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment updates outdated language and
				  terminology.
(1) Definitions.
(A) Community services-Supports funded and
				purchased through the Department of Mental Health Purchase of Service (POS)
				system with general revenue appropriations to assist individuals who have an
				intellectual developmental disorder and/or developmental disabilities to live
				in the community. Eligibility for MO HealthNet is not required. Community
				services includes services for people with autism spectrum disorders funded
				with general revenue appropriations and administered through the Autism
				Projects defined at 9 CSR 45-3.060.
(B) Community Support waiver-A set of
				services, not including residential services, for MO HealthNet eligible
				individuals who have an intellectual developmental disorder and/or a
				developmental disability who have been determined to otherwise require the
				level of care provided in an ICF/DD.
(C) Comprehensive waiver-A set of services,
				including residential services, for MO HealthNet-eligible individuals who have
				an intellectual developmental disorder and/or a developmental disability who
				have been determined to otherwise require the level of care provided in an
				ICF/DD.
(F) Division-Division of
				Developmental Disabilities.
(G)
				Intermediate care facility for intellectual developmental disorder and/or a
				developmental disability-Any facility certified under
				42 CFR
				440.150. These facilities are referred to as
				intermediate care facilities for developmental disabilities (ICF/DD) throughout
				this rule.
(H) Missouri Children
				with Developmental Disabilities waiver (MOCDD)-A set of services, not including
				residential services, for children under the age of eighteen (18) living with
				their parents, who will qualify for MO HealthNet by qualifying for the waiver,
				who have an intellectual developmental disorder and/or a developmental
				disability who have been determined to otherwise require the level of care
				provided in an ICF/DD.
(I)
				Partnership for Hope waiver-A set of services, not including residential
				services, for MO HealthNet-eligible individuals who have an intellectual
				developmental disorder and/or a developmental disability who have been
				determined to otherwise require the level of care provided in an ICF/DD. The
				Partnership for Hope is a county-based waiver operational in any Missouri
				county with a levy authorized under section
				205.968, RSMo, whose board of
				directors has authorized funds to support the Partnership for Hope waiver or in
				any Missouri county approved by the Centers for Medicare and Medicaid Services
				for inclusion in this waiver.
(J)
				Prioritization of Need (PON) scoring-A process that assigns a score to the
				level of need for an individual, as set forth in
				9 CSR
				45-2.017. PON scoring is used to determine access to
				services when funding is limited and shall be applied to all individuals prior
				to participation in any of the following programs:
1. Comprehensive waiver;
2. Community Support waiver;
3. Missouri Children with Developmental
				Disabilities waiver (MOCDD); or
4.
				Community services funded with general revenue appropriations and purchased
				through the Department of Mental Health Purchase of Service (POS)
				system.
(K) Waiting
				list-A list of all people who have qualified for but are not currently
				receiving services from the division. The waiting list shall be subdivided into
				the following categories:
1. Children under
				the age of eighteen who are not eligible for MO HealthNet, who have needs that
				require the level of care in an ICF/DD, and who would otherwise be eligible for
				the MOCDD waiver;
2. Individuals
				who are eligible for MO HealthNet who have needs that require the level of care
				in an ICF/DD and are otherwise eligible for the comprehensive waiver;
				and
3. Individuals who are eligible
				for MO HealthNet who have needs requiring the level of care in an ICF/DD, who
				do not have an immediate need for residential services but have service needs
				beyond the scope of the Partnership for Hope waiver; and
4. Individuals who are eligible for MO
				HealthNet, who have needs requiring the level of care in an ICF/DD, whose needs
				can be met safely with services in the Partnership for Hope waiver.
5. Children and adults who are eligible for
				MO HealthNet, who have needs requiring the level of care in an ICF/DD, whose
				needs can be met safely with services in the Partnership for Hope
				waiver;
6. Children age three
				through eighteen (3-18) with autism spectrum disorder who have needs requiring
				the level of care in an ICF/DD and who are eligible for MO Health-Net;
				and
7. Children who have needs
				requiring the level of care in an ICF/DD and who are not eligible for MO
				HealthNet.