Missouri's Home and Community Based Services system runs on Section 1915(c) waivers, and its HCBS manual names four of them: the Aged and Disabled Waiver, the Adult Day Care Waiver, the Independent Living Waiver, and the Structured Family Caregiving Waiver. A participant can only be enrolled in one HCBS waiver at a time, even though different state agencies administer different programs.
The Aged and Disabled Waiver is the one built for people age 63 or older with assessed impairments and unmet needs serious enough that nursing-home care would otherwise be required. Services on the list include homemaker help, chore assistance, respite care, home-delivered meals, and adult day care, with the Department of Health and Senior Services' Division of Senior and Disability Services running the program through an agreement with the MO HealthNet Division.
Two of the other waivers come with real capacity limits worth planning around: the Independent Living Waiver has a limited number of slots and a waitlist once they're full, and the Structured Family Caregiving Waiver is likewise capped by waiver-year slot availability.
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