PDN Clarification to include MFAW

PDN Providers:

Please see below for the recent memo from MO HealthNet regarding clarification to PDN Policy:

Private Duty Nursing Policy Clarification

Applies to: Private Duty Nursing (Healthy Children and Youth and Medically Fragile Adult Waiver) Providers

Effective date: May 1, 2024

The MO HealthNet Division (MHD) Private Duty Nursing (PDN) Program and 1915(c) Home and Community-Based Waiver titled Medically Fragile Adult Waiver (MFAW) are administered jointly by the Department of Social Services, MO HealthNet Division (DSS/MHD) and the Department of Health and Senior Services, Bureau of Special Health Care Needs (DHSS/BSHCN). Policy regarding the Healthy Children and Youth (HCY) and MFAW PDN assessment and service planning processes were revised 5/1/24, to allow participants more flexibility in the utilization of PDN services.

Provider Bulletin Volume 46 Number 55, dated 4/22/2024, was posted with an effective date of 5/1/24, outlining changes to HCY policy. The intent was for that bulletin to apply to both HCY PDN and MFAW PDN and MFAW was inadvertently not included in the bulletin.

Changes to policy include:

• PDN services will be authorized as a total number of units per month, based on weekly hours, which are determined by the assessed medical needs of the participant. Participants or their responsible parties will continue to schedule services through their providers to meet their needs throughout the month and must stay within the authorized number of monthly units.

• Monthly service authorizations will be based on a maximum of 112 hours per week, unless otherwise authorized by BSHCN. Participants or their responsible parties will still contact their Service Coordinator (SC) to report any changes that could necessitate a change in authorized monthly units.

Please review the updated HCY Guidebook and MFAW Guidebook policies for more information.

Click here to access the memo.

Thanks,

Carol Hudspeth

Executive Director