Home & Community Based (HCB) Waiver Services / Program of All-Inclusive Care for the Elderly (PACE)

FORMS: IM-54A Referral for Home and Community Based Waiver Services
(downloadable Word template)

 

ONLINE RESOURCES

PACE (Program of All-Inclusive Care for the Elderly)
IM-4 Home and Community Based Service
HCB vs HCBS Chart

 

PURPOSE:

The HCB program is part of the nursing home diversion program called Missouri Care Options. The purpose of the program is to give equitable treatment to persons choosing to remain in their own homes rather than enter a nursing facility and equitable consideration to the resources for married couples by allowing a division of assets. HCB also establishes a higher income level for all individuals receiving benefits to encourage them to remain at home, which is cost effective for MO HealthNet.

 

The non-spenddown income limit is the same as the HCB Waiver limit. If the income exceeds the HCB limit, regular spenddown budgeting and procedures are followed using the SSI maximum as the income limit. Division of Assets rules apply for those with income below the HCB limit.

 

PACE has been unavailable since May 1, 2016 due to lack of providers.

 

REQUIREMENT:

There are four general requirements for individuals to receive MO HealthNet under the HCB criteria. The individual must be:

  • Age 63 or older. If under age 65, the 1973 PTD criteria must be established.
  • Determined by the Department of Health and Senior Services (DHSS) to:
    • Require a nursing facility (NF) level of care
    • Be authorized to receive HCB services
    • DHSS determination is requested by submitting an IM-54A Home and Community Based Referral or by calling DHSS.
  • Income equal to or less than the HCB monthly income limit.
  • Below the permitted available resource limits. A married couple requires a Division of Assets for HCB benefits. See Division of Assets this guide

Individuals who do not meet the eligibility requirements for HCB waiver services may be found eligible for MO HealthNet using any MHABD criteria.

 

PROCEDURE:

Refer applicants interested in HCB to DHSS/DSDS for a determination of medical need and authorization via IM-54A Home and Community Based Referral. Enter the referral information on the Home and Community Based / PACE Information screen in FAMIS.