Missouri public administrators tell House panel shortages in community placements, Medicaid delays push vulnerable adults into nursing homes and jails

St. Louis County Public Administrator Timothy Weeks told the Missouri House Committee on Health and Mental Health on Monday that lengthy Medicaid eligibility and waiver delays, combined with a shortage of crisis placements, are forcing some Missourians with severe mental illness or developmental disabilities into skilled nursing facilities or the criminal-justice system.

"It took over 13 months to get [one client] approved for Medicaid," said Timothy Weeks, St. Louis County Public Administrator. "In the meantime, he lost his waiver slot with the Department of Mental Health. He had to be moved out of a community placement where he was thriving."

Weeks said his office is responsible for more than 500 people and more than 700 cases with a staff of 12, and that the average profile of new wards is growing younger and more behaviorally acute. "We're getting individuals who are aging out of Children's Division custody at age 21 or even at 18," he said. "Families are giving up. Families need help."

Jackson County Public Administrator John Killian told the committee that Missouri's long…