Missouri manual section 6.14
Health assessment and coordination
Official service name: Health Assessment and Coordination Services
Health Assessment and Coordination provides disability-informed telemedicine consultation for people receiving developmental-disability waiver services. It can help a person, family, or support provider understand symptoms, decide the next clinical step, coordinate with local medical care, and receive follow-up after the initial call.
What the manual describes
What this service can help with
- Real-time consultation about health symptoms for a person with an intellectual or developmental disability
- Video-assisted examination, treatment planning, and discussion with the person or caregiver
- Coordination with an emergency department, urgent care, or primary care physician when additional treatment is needed
- Disability-specific consultation for families and direct-support professionals
- Follow-up consultation within 18 hours of the initial call
Source-backed working pathway
To establish you'll probably need:
These steps translate the cited manual section into a practical review sequence. Confirm the current local process before acting.
Identify the health-coordination need in person-centered planning.
Describe recurring uncertainty, communication barriers, avoidable emergency-department use, caregiver training needs, or other disability-specific health coordination that the service should address.
Confirm that the service complements regular medical care.
Document the person's primary care and local emergency or urgent-care pathways, and confirm that the proposed support will not duplicate state-plan care or replace needed in-person examinations.
Identify a qualified Health Assessment and Coordination provider.
Confirm the provider's licensure, board status, developmental-disability experience and training, 24-hour call-center capacity, technology and privacy safeguards, and Department contracting requirements.
Plan how consultations and escalation will work.
Record who may call, what health information should be available, how video consultation will occur, when local emergency or in-person care will be used, and how the provider will communicate with caregivers and medical professionals.
Confirm authorization, access instructions, and follow-up.
Verify the authorized service period and monthly unit, obtain the provider's 24-hour access instructions, and confirm how the required follow-up within 18 hours of the initial call will be documented.
Important boundaries
Limits that may affect fit or authorization
- The manual describes this as consultative telemedicine and coordination with local medical providers; it is not a replacement for needed emergency or in-person medical care.
- The service must not replace an in-person examination when one is needed.
- The service does not replace the need for a primary care physician.
- The service cannot duplicate care available through the Medicaid state plan; it is intended to connect and coordinate with covered medical services.
- Virtual delivery must meet the additional requirements in Manual Section 7.
- The manual lists one unit per month and no more than 12 units per annual person-centered service-plan year.
- Being enrolled in a waiver does not by itself establish that this service is authorized or currently available from a provider.
- Comprehensive and Community Support waivers remain under a temporary renewal extension through December 27, 2026, or until CMS grants final approval. Confirm the currently approved rules with the support coordinator; proposed renewal changes are not automatically active.
Do not assume this part
Questions to confirm locally
- Which health situations should prompt a call to this service, and which require local emergency or immediate in-person care?
- How will this service coordinate with the person's primary care physician, urgent care, and emergency department?
- Does the proposed support duplicate any Medicaid state-plan service?
- Is the provider qualified and currently contracted for this service?
- What technology or communication accommodations are needed for video consultation?
- How will the 18-hour follow-up occur?
- What monthly authorization applies, and how will calls and outcomes be documented?