Specialized 
Services

Healthy Children and Youth (HCY) Services: This program provides service coordination and medically necessary care—like in-home nursing and personal care—for children and young adults from birth to age 21.

• Age: Birth through age 20.

• Residency: Must be a Missouri resident.

• Medicaid: Must be enrolled in MO HealthNet (specifically fee-for-service).

• Medical Need: Must require "medically necessary" services to address health or developmental conditions. 

 

Private Duty Nursing (PDN): Offers specialized one-on-one medical care (typically 4 to 24 hours per day) for medically fragile patients, often managed by RNs or LPNs.

• Age: Primarily for children/youth under age 21. Adult coverage may be available via the Medically Fragile Adult Waiver for those transitioning from HCY.

• Care Intensity: Requires a continuous "block of nursing" (at least 4 hours per day) that exceeds what a family can provide alone.

• Clinical Criteria: Advanced support needs such as ventilator dependency, tracheostomy care, or complex tube feedings. 

 

Brain Injury Services (Adult Brain Injury Program/Waiver): Aimed at Missouri residents (typically ages 21–65) with a traumatic brain injury (TBI), these services include cognitive rehabilitation and personal care to help them remain independent at home.

• Age: Generally between 21 and 65 years old.

• Diagnosis: Must have a documented Traumatic Brain Injury (TBI).

• Level of Care: Must meet the criteria for a Nursing Facility Level of Care.

• Financial: Must meet MO HealthNet income and asset limits (income at or below 185% of Federal Poverty Level for certain funded services). 

 

Services for the Blind: Programs like Rehabilitation Services for the Blind (RSB) provide training in daily living skills, counseling, and financial assistance through Blind Pensions for eligible residents.

• Eligibility: Based on the severity of vision loss in both eyes as determined by a medical professional.

• Age: No specific age limit for many training and rehabilitation services.

• Financial: Most services from Rehabilitation Services for the Blind (RSB) are free; however, the Prevention of Blindness program may have specific income qualifications.