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St. Louis regional office details intake, eligibility and waiver steps for developmental disability services
Summary
Rachel Cox of the Missouri Department of Mental Health—s Division of Developmental Disabilities outlined how regional intake works: four-stage intake, document verification, the virtual MOSS assessment (about 90 minutes), timelines for contact and appeals, and how Medicaid status affects referrals to local coordinators.
Rachel Cox, intake supervisor with the Missouri Department of Mental Health—s Division of Developmental Disabilities—St. Louis Regional Office, reviewed how people in the St. Louis region can apply for developmental disability services and what determines eligibility.
Cox said the intake process has four stages: referral and application; record verification; assessment using the Missouri Adaptive Ability Scale (MOSS); and a final eligibility determination. "The Division of Developmental Disabilities has up to 60 days to complete the assessment after all of the application paperwork and necessary records are received," she said. The MOSS assessment, Cox added, is virtual, administered by a certified assessor and "takes approximately 90 minutes to administer." Results are valid for up to three years.
Applicants or a legally responsible party must submit records that verify an intellectual or developmental disability, Cox said. Typical documentation includes educational records, IEPs or 504 plans, school evaluations, psychological or IQ testing, adaptive behavior assessments and relevant medical records. Cox noted the division does not provide diagnostic testing; evaluations must be completed before applying.
Cox described eligibility thresholds: an intellectual disability must be present before age 18 and a developmental disability before age 22, and eligibility hinges on substantial functional limitations in major life areas as measured by adaptive behavior assessment. She characterized waiver-level care as generally requiring an individual to meet an ICF/ID level of care and be at risk of institutionalization; for one waiver standard she cited a MOSS threshold of about "95% below average in three major life areas."
How applicants are routed depends on Medicaid enrollment and county of residence. Cox said that for individuals enrolled in MO HealthNet (Missouri Medicaid) the intake unit will refer eligible applicants within three business days to either state support coordination or contracted targeted case management agencies. She named local providers serving St. Louis County, St. Louis City, St. Charles County and Jefferson County as examples.
If the intake unit determines an applicant is ineligible, Cox said the division will notify the individual or responsible person within one business day and explain appeal options. The process is progressive: appeal first to the regional office director (request within 30 days; director decision within 10 business days), then to an impartial hearing referee (decision within 30 calendar days), and finally to circuit court under Chapter 536 of the Revised Statutes of Missouri.
Cox also summarized waiver programs and typical services available across waivers, including applied behavior analysis, assistive technology, environmental accessibility adaptations, individualized supported living, respite care, dental care, therapy services, supported employment and transportation. She cautioned that access to waiver services depends on priority of need and available funding.
For help starting an application, Cox provided the intake line (314-5874800, Monday'Friday, 8 a.m.'4:30 p.m.) and an intake leadership contact (dm.d.intmh.mmo.gov). FACE staff shared a feedback QR code and provided their contact email (face@ssdmmo.org) and team phone (314-9898460). The presentation concluded with an offer for attendees to ask follow-up questions to intake staff.
