Missouri manual section 6.17
Individualized skill development
Official service name: Individualized Skill Development
Individualized Skill Development provides personalized, episodic teaching for a person who lives in their own home or family home and wants to build or maintain a clearly identified complex skill for greater independence. It is focused skill instruction, not ongoing personal assistance or a general residential support service.
What the manual describes
What this service can help with
- Learning domestic and home-maintenance skills
- Building budgeting and money-management skills
- Learning to use public transportation
- Acquiring, practicing, or maintaining another clearly identified complex skill needed for independence
- Using individualized teaching methods tied to the person's goals and person-centered service plan
- Practicing the identified skill individually or in a small group
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 one clear independence skill with the support coordinator.
Describe the complex skill the person wants to acquire, improve, or maintain, why it matters for independence, and what successful use of the skill would look like. The person-centered service plan should identify the skill and expected outcome.
Confirm living arrangement and nonduplication.
Confirm that the person lives in their own home or family home, is not receiving Group Home, Individualized Supported Living, or Shared Living, and is not requesting instruction that belongs to school, Healthy Children and Youth, ordinary parental support, or another service.
Define the individualized teaching plan.
Identify the teaching approach, settings for practice, individual or group format, assistance needed to participate, expected frequency and duration, and the progress information that will show whether the skill is becoming more independent.
Identify a qualified skill-development provider.
Confirm that the agency is qualified to provide Individualized Skill Development, has a Department of Mental Health contract, and uses staff who meet the manual's training and credentialing requirements. A family member or guardian cannot be the provider.
Confirm authorization, schedule, and progress documentation.
Before services begin, confirm the approved skill, hours, individual or group arrangement, locations, transportation included during instruction, and required progress notes. As practical preparation, ask how teaching strategies will be adjusted if the person is not making progress.
Important boundaries
Limits that may affect fit or authorization
- The service is for a person living in their own home or family home and must address a clearly identified complex skill through episodic support.
- A person receiving Group Home, Individualized Supported Living, or Shared Living cannot receive Individualized Skill Development because skill development is already part of those services.
- A person may receive Day Habilitation, but Individualized Skill Development cannot be provided at the Day Habilitation location.
- For a minor child, the service cannot replace ordinary parental support, school responsibilities, or Healthy Children and Youth services.
- A family member or guardian cannot provide this service.
- Personal-assistance tasks may be part of the service when needed, but they cannot make up the entire service.
- A group cannot include more than four people.
- Transportation during community-based skill instruction is included in the service rate.
- The manual's billing table lists a maximum of 348 fifteen-minute units, or 87 hours, per month for individual or group Individualized Skill Development. Current authorization and billing rules must be confirmed before relying on that amount.
- 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
- Is Individualized Skill Development included and authorized in the current person-centered service plan?
- Is the requested outcome a clearly identified complex skill rather than ongoing personal assistance or general support?
- Does the person's living arrangement meet the service definition, and are any residential, day, school, Healthy Children and Youth, or other services duplicative?
- Which qualified providers currently serve the person's location and can teach the identified skill?
- Will instruction be individual or group, and does any group stay within the four-person limit?
- How will progress toward independent use of the skill be measured and reviewed at least annually?
- What current hours, locations, transportation arrangements, documentation, and start procedure are authorized?