Missouri Appleseed is thrilled to announce the receipt of a two-year grant to support Missouri’s section 1115 waiver work. The funding is from the Missouri Foundation for Health, a significant supporter of Missouri Appleseed’s work and a leading health policy foundation in our state.
Submitting a section 1115 waiver requires states to complete substantial research, planning, coordinating, and drafting work. Missouri Appleseed will support the state’s efforts by:
1. Coordinating County-level Stakeholders
The Department of Social Services, MO HealthNet, and the Department of Corrections will draft Missouri’s section 1115 waiver. These are state-level administrators and not involved in the administration of county jails. Missouri Appleseed is committed to engaging county-level stakeholders so that people in county jails will also benefit from the waiver. We will continue to coordinate with the Missouri Sheriffs’ Association and Missouri Association of Counties to ensure the engagement and involvement of sheriffs, jail administrators, and county commissioners in state-level drafting efforts.
2. Collecting Critical Data
The Centers for Medicare and Medicaid Services (CMS) requires that all section 1115 waiver applications report both state- and county-level incarceration data. However, Missouri has no central database to collect and disseminate county-level incarceration data. Missouri Appleseed will distribute surveys to each jail and county in Missouri to collect data as required by CMS for waiver applications. We will summarize and share this data with the state so they can incorporate it into their section 1115 waiver draft.
3. Hold Focus Groups with Stakeholders
CMS requires states to use feedback from formerly and currently incarcerated Medicaid members to inform the states’ waiver plans. However, state agencies do not always have the ability to collect this data and are prohibited from providing incentives for participation. To fill this gap, Missouri Appleseed will travel to different parts of the state to hold paid focus groups with currently and formerly incarcerated individuals. We will ask about focus group participants’ use of Medicaid and challenges accessing needed healthcare, sharing the results with the state.
4. Hosting a Stakeholder Convening
Perhaps the biggest lift for this grant funding, Missouri Appleseed will host a convening in 2025 to gather representatives from at least fifty stakeholder organizations. Sheriffs, commissioners, public defenders, social workers, health care providers, advocates, and state employees all have valuable input for how the system should work and what Missouri’s section 1115 waiver should include. For example, one of our key recommendations will be for the DOC and county jails to work with local healthcare providers to provide Medicaid-reimbursable services; the convening will provide us with the opportunity to bring sheriffs and FQHCs together to determine how these partnerships could look. Missouri Appleseed will bring in facilitators to gather this kind of data and insight from stakeholders to provide a set of recommendations to the state.
The grant funding will allow Missouri Appleseed to hire a new Program Manager to implement much of this work. The Program Manager will have experience applying for and/or navigating Medicaid, past experience working with currently or formerly incarcerated individuals, and strong coordination skills. Interested applicants should submit a cover letter, resume, and three references by February 15th to Mary Quandt (mquandt@appleseednetwork.org).
Missouri Appleseed is excited for the opportunity to support Missouri’s section 1115 waiver work!