MO Partnership for Hope Waiver (PFH)

Published on
July 21, 2023
Last updated
February 29, 2024
Written by
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Katie Wilkinson
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Discover the significance of the Partnership for Hope Waiver (PFH), a county-based Medicaid program in Missouri prioritizing individuals in crisis, advocating for caregiver compensation, and providing a comprehensive range of services to enhance the lives of adults and children.
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The Partnership for Hope Waiver (PFH) is a pivotal Medicaid program serving adults and children whose requirements can be met within their existing community support system. With a strong emphasis on addressing crises, this waiver prioritizes individuals facing immediate harm or endangerment, caregiver loss, or abuse. As we delve deeper into the PFH, it becomes apparent that it not only fills a critical gap in healthcare but also seeks to recognize and support the invaluable contribution of family caregivers.

Overview of the Partnership for Hope Waiver

The Partnership for Hope Waiver (PFH) is a county-based Medicaid waiver program in Missouri that plays a significant role in healthcare, providing essential support to vulnerable individuals and families in crisis. Created to bridge the gap between institutional care and community-based services, the PFH aims to effectively enhance the lives of adults and children by utilizing existing community support systems.

The primary purpose of the PFH waiver is to enable individuals with significant health and safety needs to remain in their homes or community settings while receiving necessary services and support. By doing so, the program strives to prevent unnecessary institutionalization and promote individual independence and community integration.

The PFH targets individuals and families facing critical circumstances, including those at risk of immediate harm or death due to health and safety conditions, individuals who have experienced a change in caregiver status rendering them unable to meet their needs adequately, and those enduring abuse, neglect, or exploitation.


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Eligibility Requirements for the Partnership for Hope Waiver

To be eligible for the Partnership for Hope Waiver (PFH) program, individuals must meet specific criteria to address their critical needs while maximizing community-based support. The eligibility requirements are as follows:

  1. Missouri Medicaid Eligibility: Applicants must be eligible for Missouri Medicaid, which typically includes meeting income and asset limits set by the state.
  2. Division of DD Services Criteria: Eligible individuals must meet the eligibility criteria for Division of Developmental Disabilities (DD) services. This involves having a qualifying developmental disability or related condition.
  3. Community Support System Adequacy: The person's needs must be suitable for being met through the current community support system and waiver services. The annual cost of these services must be, at most, $12,362.
  4. ICF/ID Level of Care: The individual must meet the level of care criteria required for placement in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/ID).
  5. Residency in Participating County: The person seeking PFH waiver services must reside in a county that participates in the program.
  6. Crisis Criteria or Priority Criteria: The individual must meet the crisis criteria, which includes situations posing immediate harm or danger to themselves or others. Alternatively, the person can meet one of the following Priority Criteria:
    > Substantial accommodation needs beyond the capacity of their primary caregiver.
    > Exhaustion of educational and Vocational Rehabilitation (VR) benefits with a need for pre-employment or employment services.
    > Continued need for local funding support for at least three months.
    >The transition from a non-Medicaid funded residential care facility to a less restrictive community environment with access to Prevention Waiver Services.

Meeting these eligibility requirements ensures that individuals with critical needs can access the essential supports and services the Partnership for Hope Waiver provides, enabling them to remain in their communities while receiving the necessary care and assistance.

Services and Supports under the Partnership for Hope Waiver

The Partnership for Hope Waiver (PFH) offers a comprehensive range of services and supports to eligible individuals, ensuring they receive the necessary care and assistance to lead fulfilling lives within their communities. The PFH program's services include:

  1. Applied Behavior Analysis (ABA): Behavioral therapy and intervention for individuals with developmental disabilities.
  2. Assistive Technology and Specialized Medical Equipment/Supplies: Access to tools and devices that aid individuals with disabilities in daily activities.
  3. Community Services: Various community-based supports, including Community Integration, Community Specialist, and Community Transition services.
  4. Day Habitation: Programs and activities tailored to enhancing skills and promoting independence during daytime hours.
  5. Dental Care: Dental services to maintain oral health and hygiene.
  6. Environmental Accessibility Adaptations: Home modifications to increase accessibility for individuals with mobility challenges.
  7. Family Peer Support: Assistance and guidance provided to family members caring for individuals with developmental disabilities.
  8. Employment Services: A range of services, including Career Planning, Individualized Skill Development, Job Development, and Supported Employment, aimed at fostering employment opportunities and vocational growth.
  9. Occupational, Physical, and Speech Therapy: Therapy services to address specific developmental, physical, or communication needs.
  10. Personal Assistant, Person-Centered Strategies Consultant (PCSC), and Support Broker: Supportive personnel who provide personalized care plans and assistance.
  11. Prevocational Service: Training and preparation for individuals seeking to enter the workforce.
  12. Professional Assessment & Monitoring: Regular assessments and monitoring to ensure the individual's evolving needs are met appropriately.
  13. Temporary Residential: Short-term residential support when required, such as respite care.
  14. Transportation: Access to transportation services for community integration and medical appointments.

The array of services and supports offered by the PFH waiver aims to foster independence, enhance the quality of life, and empower individuals with developmental disabilities to thrive within their communities. By catering to diverse needs, the PFH program creates an inclusive and supportive environment for eligible individuals and their families.


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Compensation for Caregivers under the Partnership for Hope Waiver

The Partnership for Hope Waiver (PFH) stands apart from traditional Medicaid programs by recognizing the vital role of family caregivers and advocating for their compensation. Unlike many other programs where family caregivers often go unpaid, the PFH offers a self-directed option that allows eligible care recipients or their representatives to hire and pay their chosen caregivers, including family members, for the care they provide.

Through the self-directed option, eligible individuals can receive compensation for family caregivers meeting the program's requirements. Caregivers can receive payment for their services, acknowledging their dedication and contribution to the individual's care and well-being.

Caregivers need to adhere to the program's documentation and reporting procedures to access compensation. This typically involves maintaining records of the care provided, the hours worked, and related expenses. The PFH may have specific guidelines and reporting forms that caregivers must follow to ensure accurate documentation and appropriate reimbursement. By implementing the self-directed option, the PFH empowers caregivers and recognizes their significant impact within the healthcare system.

Learn more about Medicaid self-directed care >>

A Note from Givers

To access DD services, contact the Regional Office or Satellite Office in your county of residence. An Intake worker conducts a preliminary interview in person or over the phone to collect basic demographic information. You will then receive an application, which can be completed and signed by you or a responsible party. The application can be returned to the appropriate Regional/Satellite Office in person or by mail. The eligibility process will begin once the application is validated.

If you or someone you know provides essential care to a loved one under the PFH program, fill out this form to determine if you qualify for compensation.

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