Missouri Partnership for Hope Waiver and MOCDD Waiver: Eligibility, Caps, and How to Apply

Missouri's DD Waiver Landscape

Missouri operates four Medicaid Home and Community-Based Services (HCBS) waivers for individuals with intellectual and developmental disabilities. Two of them — the Comprehensive Waiver (no annual cap, for 24-hour residential needs) and the Community Support Waiver ($28,000 annual cap, for in-home and day services) — are well known to families deep in the system.

But two others are less understood and serve distinct populations: the Partnership for Hope Waiver and the MOCDD (Sarah Jian Lopez) Waiver. Both have specific eligibility requirements and financial structures that families need to understand before the student exits high school.

Partnership for Hope Waiver

The Partnership for Hope (PFH) Waiver targets individuals who need lower levels of support to stay in their homes and communities — enough to prevent or delay institutionalization, but not the intensive services that the Comprehensive or Community Support waivers fund.

Annual service cap: $12,362 per participant per year.

Funding structure: PFH is unique because it's jointly funded by federal Medicaid, state appropriations, and local Senate Bill 40 (SB40) county tax levies. Not every county in Missouri participates — the waiver is only available where the local SB40 board has agreed to provide the county match. Check with your regional SB40 board to confirm your county participates.

Services funded: Basic personal assistance, minor home modifications (ramps, grab bars), specialized medical equipment, short-term respite care, dental services, and assistive technology. PFH does not provide residential services; ask the regional office which day or employment services are currently authorized under the waiver.

Who it's for: Individuals who live with family or independently and need targeted supports — a few hours of personal assistance per week, occasional respite for family caregivers, or assistive devices — rather than comprehensive daily services.

MOCDD (Sarah Jian Lopez) Waiver

The MOCDD Waiver serves a different population entirely: children with developmental disabilities under the age of 18 who would otherwise require institutional-level care.

No specific annual service cap — but services are tailored to the child's assessed needs.

The critical eligibility detail: MOCDD evaluates only the child's individual income and resources for Medicaid eligibility, completely disregarding parental assets and income. This is a significant advantage for families who earn too much to qualify for standard Medicaid but whose child needs waiver-funded services.

Services funded: Day habilitation, in-home respite, personal assistant services, support broker, and applied behavior analysis (ABA). The MOCDD waiver provides health coverage and in-home supports while the student is still in school.

Transition implication: Children on the MOCDD waiver age out at 18. Families must plan the transition to an adult waiver (Partnership for Hope, Community Support, or Comprehensive) before the child's 18th birthday. Starting the adult waiver application process well before school exit gives the regional DMH office time to assess needs and match the appropriate program.

The Prioritization of Need Score

When demand for waiver slots exceeds available funding — which is the norm in Missouri — DMH uses a Prioritization of Need (PON) score to set priority on the waiver waiting list.

PON scores run from 1 to 5. Scores 1 through 4 are based on the individual's overall Missouri Adaptive Ability Scale (MAAS) score; PON 5 is based on verified crisis criteria. Higher PON scores receive priority before lower scores, with time on the list relevant among people with the same score.

Students exiting high school may need to document the loss of school-based supports as part of transition planning. This is why initiating the DMH intake process early matters: the assessment needs time to capture the gap between school services and available adult supports.

The MAAS Assessment

The Missouri Adaptive Ability Scale (MAAS) is one of the tools DMH uses to evaluate functional limitations for waiver eligibility. It measures adaptive behavior across domains like self-care, communication, social skills, community participation, and safety awareness.

The MAAS feeds directly into the Level of Care determination — the threshold question that every HCBS waiver requires. To qualify for any of Missouri's DD waivers, the individual must meet the Level of Care standard for an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). The MAAS helps establish whether that threshold is met by documenting functional limitations in concrete, measurable terms.

Families can prepare for the MAAS by keeping records of the student's daily support needs, documenting which tasks require assistance, and noting any safety concerns related to independent functioning. Bring these records to the DMH intake meeting.

How to Apply

1. Contact the DMH Division of Developmental Disabilities regional office serving your county. The regional intake office needs to confirm the student's developmental disability diagnosis, assess functional limitations, and open a case file.

2. Ensure the student has active Missouri Medicaid (MO HealthNet) coverage. At 18, the student is treated as a household of one — parental income no longer counts. Apply for Medicaid in the student's own name immediately upon their 18th birthday.

3. Request a Service Coordinator (Targeted Case Manager) through DMH or your local SB40 board. The Service Coordinator will facilitate person-centered planning, develop the Individual Support Plan (ISP), and submit waiver applications.

4. Maintain Medicaid continuously. If Medicaid lapses, all waiver-funded services stop immediately — there is no grace period.

The Missouri IEP Transition to Adulthood Guide includes a DD Waiver Comparison worksheet that maps each waiver's cap, services, and eligibility criteria side by side, plus a step-by-step DMH intake checklist timed to your student's age milestones.

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