Missouri program
Nursing hours at home through MO HealthNet
Nursing at home for children under 21 who need sustained skilled care beyond what family can provide.
What it is
Nursing at home for children under 21 who need sustained skilled care beyond what family can provide.
Home nursing can support a child whose medical needs make home care difficult. The test looks at skilled nursing tasks and how much help the family can provide. A cancer diagnosis alone does not decide the hours.
Eligibility rules
- Your child must have MO HealthNet, be under 21 and need at least a four-hour block of skilled nursing daily beyond the family’s ability to provide it.
What you get
- No charge for approved nursing for a child on MO HealthNet.
- An RN or LPN parent employed by an enrolled nursing agency can provide approved hours.
What the help includes
- An RN or LPN family nurse must work for an enrolled private-duty-nursing agency. Approved family-nurse hours are limited to 12 daily and 40 weekly; these are not limits on the child’s total approved hours.
- The doctor's care plan is reviewed every 60 days. Occasional nurse visits are a different service with a different test; the four-hour block is only for shift nursing.
If you decide to apply
- Ask the oncology team to describe the nursing tasks and request approval through your child’s MO HealthNet plan.
- If coverage runs directly through the state, discuss the request with the Bureau of Special Health Care Needs at 800-451-0669.
Your child’s MO HealthNet plan, or DHSS for direct state coverage: 800-451-0669 · Official page ↗
After you apply
- A denial or reduction notice identifies the review route. A plan appeal, state hearing and request to keep existing services have separate deadlines.
- Ask the care manager whether the request goes to the health plan or to the state, and when the answer is due.
- The health plan must answer a nursing request within seven days, or 72 hours when urgent.
Good to know
Approval and finding an available nurse are separate steps; ask the agency how the hours will be staffed before discharge.
Other details
- Ordinary basic and advanced personal care exclude parents and other listed family members as paid workers. The licensed-family nursing exception is different. Your care manager can check other age-appropriate services and any separate waiver worker rules.
Official sources
“Could you assess whether our child needs nursing at home? What help and practical limits would it bring, and could you help request it if the care test fits?”
Why I’m asking: I want to understand what care we can safely manage at home and where a nurse could help.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Say plainly what the nights look like, in hours, and keep a diary for a week.
Your social worker
The oncology team writes the request and sends it to the right authoriser.
The care team
The doctor documents the skilled need and the hours.
- Who decides
- Your MO HealthNet health plan, or the state Bureau of Special Health Care Needs for fee-for-service
- Ask the care team
- “We cannot manage the nights. Can you request private duty nursing, and do we send it to our health plan or to the state bureau?”
How to apply
First step: Ask the oncology team this week to request private duty nursing, and check which authoriser your coverage uses.
- Ask the oncology team to write what the nights actually need, in hours.
- Check your MO HealthNet card: if it names a health plan, the request goes to that plan.
- If a parent is a licensed nurse, ask an enrolled agency about employing them.
Official application / program page ↗
Where it starts: Ask the oncology team to request prior authorisation. If your child is in a managed-care plan, the request goes to that plan; otherwise to the state bureau on 573-751-6246 or 800-451-0669.
What to gather
The diagnosis letter, the child’s insurance card, and the last two pay stubs cover most applications. The official page lists the rest.
How long: Missouri publishes no decision deadline and no measured waiting time for staffing.
What a yes looks like
An authorisation naming the hours a week, and an agency to arrange them.
What a no looks like, and the next move
A denial, cut or stop letter. Each carries a state fair-hearing right; if no letter arrives, call Constituent Services on 800-392-2161.
Watch out
- If your card names a health plan, the request goes to that plan, not the state bureau.
- A parent can be paid only as a licensed nurse employed by an enrolled agency.
- Finding a nurse, not getting approval, is usually the delay.
Dates that change this
2026-06-01: A June 2026 form names the programme Medically Complex Children and Youth. The date the name changes was not published, so both names may be in use. (not yet confirmed against the final rule)
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
Paid nursing hours at home. A licensed parent can provide up to 12 hours a day and 40 hours a week.
- $12 — Daily maximum a family member or legal guardian may provide
- $40/week — Weekly maximum a family member or legal guardian may provide
- $4 — Minimum daily nursing need for eligibility
Covers: Skilled nursing in the home · Whatever else is medically necessary for a child under 21 under Healthy Children and Youth
Legal protection: A state fair hearing whenever services are denied, reduced or stopped
What it costs the family: No charge for approved nursing for an eligible child on MO HealthNet; a nurse’s availability and the approved service hours are separate questions.
The eligibility facts, as published
- Age
- under 21
- Age max exclusive
- 21
- Level of care
- a medical need for at least a four-hour block of nursing a day beyond the family's ability to give it
- Coverage condition
- the child must be on MO HealthNet
- Residency
- Missouri
The trap: Who approves it depends on how your MO HealthNet runs. A family in a managed-care health plan must ask that plan, not the state bureau, and the state's own page puts that instruction in its last line, where it is easy to miss. If hours are denied, cut or stopped, you have a state fair-hearing right.
Where I read this
- Private Duty Nursing for Children FAQs — Missouri Department of Social Services, read September 10, 2026
- Healthy Children and Youth (HCY) — Missouri Department of Social Services, read September 10, 2026