DSDS determines an individual’s medical need for the Personal Care Program. DSDS staff are responsible for the following:
- Making referrals to Family Support Division (FSD) for applications for Title XIX or verification of current Title XIX status
- Evaluating the need for Personal Care Services; this involves:
- completing an In-Home Assessment of the participant’s current situation; and
- working with the attending physician to obtain the Nursing Facility (NF) level of care information
- Developing a Personal Care Plan that:
- obtains the participant’s signature
- contains the attending physician’s evaluation of the necessary level of care and recommendation of Personal Care services
- obtains the physician’s signature
- establishes controls to reassess the Personal Care Plan every six months; and
- notifies FSD staff, the participant, the provider, and the MO HealthNet Division (MHD) fiscal agent of the participant’s eligibility for Personal Care services
- Authorizing the delivery of necessary services
- Communicating with FSD staff regarding:
- the joint application process; and
- changes in circumstances affecting the participant’s eligibility, on an ongoing basis
If the initial request for Personal Care services is received through DSDS, DSDS staff will:
- Inform the claimant of the necessity for Title XIX eligibility
- Contact FSD staff, by using the Referral for Services form (IM-54), requesting an application for MO HealthNet or one of the cash programs.
Note: If the individual is found to be ineligible for Title XIX services, DSDS staff will explore other resources.
If Personal Care Services are not recommended, the DSDS staff will:
- Assist the individual with other resources; and/or
- Notify FSD staff (via the IM-54) if institutionalization is requested (the SNC or MHD vendor process must be followed).