Missouri manual section 6.28
Remote supports
Official service name: Remote Supports
Remote Supports uses approved technology and remotely located staff in place of some physical staff presence. It is intended to increase independence while preserving informed choice, privacy, reliable backup support, and timely in-person response when needed.
What the manual describes
What this service can help with
- Using sensors, alerts, phone calls, or video chat to support health and safety from another location
- Reducing reliance on continuously present paid staff when remote support can safely meet the person's assessed needs
- Providing a response center that can contact the person and send in-person assistance when needed
- Supplying, installing, maintaining, and monitoring approved remote-support equipment
- Training the person, family, guardian, staff, and other involved supporters to use the system
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.
Discuss the independence goal and complete the required risk assessment.
With the support coordinator and planning team, identify which physical staff presence might safely be replaced, what the person wants to do more independently, and what risks or support needs the remote arrangement must address.
Make an informed choice between remote and in-person support.
The person and family or guardian should receive enough information to understand the equipment, staffing model, privacy protections, alternatives, and tradeoffs before consenting. The person controls the remote device and can turn it on or off as needed.
Design the privacy, monitoring, and equipment plan.
Document what equipment will be used, where it will be placed, who may activate or monitor it, how use will be logged, how other household members' privacy will be protected, and how prohibited recording and private-space rules will be enforced.
Name the responders and write the backup plan.
The person-centered service plan must name the primary contact and at least two backup responders, explain when someone must travel to the location, preserve the manual's 20-minute in-person response boundary, and cover power, system, fire, weather, medical, and personal emergencies.
Confirm the qualified provider, funding route, and authorization.
Confirm the provider's Department of Mental Health contract and business standing, compliant equipment and monitoring operations, the current annual amount, coordination with Medicaid or children's services, services that cannot overlap, documentation, and the authorized start date.
Important boundaries
Limits that may affect fit or authorization
- Remote Supports is not surveillance. It requires the person's full consent and, when applicable, the guardian's consent, plus documented informed choice and privacy protections.
- Video or web cameras cannot record audio or video, cannot be placed in or view bedrooms or bathrooms, and must be installed without invading the privacy of other people sharing the home.
- The plan must identify the primary responder and at least two backup responders. When in-person support is needed, the manual says response time must not exceed 20 minutes; emergencies should be directed to 911.
- Remote Supports cannot be provided at the same time as Individualized Supported Living, Personal Assistant, or Individualized Skill Development.
- The manual lists a $30,000 maximum per person-centered service-plan year, including equipment, and describes only a conditional exception process. Current authorization and limits must be confirmed before relying on that amount.
- For children, available Medicaid state-plan or Early and Periodic Screening, Diagnostic, and Treatment services must be used first, and Remote Supports cannot replace ordinary parental or school-system responsibilities.
- 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 in-person support is proposed to be replaced, and what evidence shows Remote Supports can meet the person's health and safety needs?
- Has the required risk assessment and informed-choice process been completed?
- What equipment will be installed, where will it be placed, and how will the person and any housemates control privacy?
- Who is the primary responder, who are the two backup responders, and how will in-person response occur within the required time?
- What happens during loss of power, connectivity, equipment failure, fire, severe weather, a medical issue, or a personal emergency?
- Could the proposed schedule overlap with Individualized Supported Living, Personal Assistant, or Individualized Skill Development?
- For a child, which Medicaid state-plan, Early and Periodic Screening, Diagnostic, and Treatment, parental, and school responsibilities must be used or preserved first?