Find where to start when your child is turning 18, turning 21, changing services, or updating paperwork.
This page is for Missouri parents and caregivers of children with medically complex needs and developmental disabilites. If something is changing - a birthday. a service, paperwork, or eligibility - this resource helps you understand what may change, what questions to ask, and who to contac next. You do need to understand the whole Medicaid or Waiver system before taking your next step.
Start With Your Situation
Where are you right now? Choose the option that best describes your situation.
My child is turning 18
Learn what may change with MO HealthNet eligibility, decision making authority, and adult services.
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My child is turning 21
Understand what may change for pediatric services, Private Duty Nursing, and adult waiver options.
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Our Medicaid paperwork or eligibility changed
Find out what to do when coverage eligibility or waiver access may be affected.
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My child's care needs or services changed
Learn what to ask when a plan of care, service authorization, or waiver fit may need to change.
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I do not know what waiver my child has
Get practical steps to find out what program your child is currently enrolled in..
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I do not know who to contact
Find a plain language guide to which agency or person handles what.
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Myths vs. Facts
- Is it true that.......Myth #1 question
Is it true that.......Myth #1 answer
- Do I have to.......Myth #2 question
Do I have to.......Myth #2 answer
- I heard that.......Myth #3 question
I heard that.......Myth #3 answer
Who Does What?
A plain-language guide to agencies and contacts.
Department of Social Services - Family Support Division (FSD)
Manages Medicaid eligibility, enrollment, and renewals.
Contact when eligibility changes, paperwork is due, or you need to update household information.
DHSS / Division of Senior and Disability Services (DSDS)
Administers certain adult waiver programs.
Contact when your child is transitioning to adult services or if you have questions about adult waiver eligibility.
DHSS / Bureau of Special Health Care Needs (BSHCN)
Supports children and young adults with special health care needs, including those using Private Duty Nursing.
Contact when your child is approaching age 21 or if PDN services may change.
DMH / Division of Developmental Disabilities (DD)
Administers developmental disability waivers and regional office services.
Contact when your child has a developmental or intellectual disability and is approaching a transition point.
Regional Offices (DMH/DD)
Local offices that manage waiver enrollment and support coordination for DD services.
Contact to ask about waiver waitlists, enrollment, or regional support.
SB40 Boards
Local boards that may provide additional supports for people with developmental disabilities.
Contact to ask about local services, funding, or supports that may supplement waiver services.
Schools / IEP Teams
Manage school-based services and transition planning under IDEA.
Contact when school services, therapy, or transition planning may change, especially before age 21 or graduation.
Support Coordinator or Case Manager
Your most direct contact for waiver services, plan of care, and transition planning.