1. GOVERNING AGENCIES

Agency: Missouri Department of Health and Senior Services (DHSS)

Role: Administers Medicaid and HCBS Waiver programs, including home-delivered meals

Agency: Missouri Department of Social Services (DSS)

Role: Oversees Medicaid provider enrollment and service authorization

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight and ensures waiver compliance

2. HOME DELIVERED MEALS SERVICE OVERVIEW

Home Delivered Meals Services focus on providing balanced, diet-specific meals to individuals in their homes. Services are personalized according to the Individual Service Plan (ISP) or Person-Centered Plan (PCP) and may include:

• Daily, weekly, or customized meal delivery schedules
• Meals tailored to dietary needs (low-sodium, diabetic-friendly, etc.)
• Delivery of hot, chilled, or frozen meals
• Nutritional assessments and meal planning support
• Safety checks during meal drop-offs

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Missouri Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Enroll as a Medicaid provider with the Missouri Department of Social Services
• Obtain a Food Establishment Permit from the Missouri Department of Health and Senior Services
• Maintain liability insurance and staff food safety certifications

4. MEDICAID PROVIDER ENROLLMENT PROCESS

Step 1: Pre-Application Contact

• Contact the Missouri Department of Social Services to understand meal service provider requirements

Step 2: Application Submission

• Submit business registration, food establishment permit, liability insurance, and service descriptions

Step 3: License Verification

• Obtain and verify the Food Establishment Permit

Step 4: Approval and Medicaid Number Assignment

• Once approved, receive a Medicaid provider number and authorization to deliver services

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business Name Registration
• IRS EIN Letter
• NPI confirmation
• Food Establishment Permit
• Liability insurance certificate

Policy & procedure manual including:

• Meal preparation and dietary compliance protocols
• Food safety and hygiene practices
• Delivery route planning and tracking
• Client intake and nutritional assessment forms
• Documentation of meal delivery and client feedback

6. STAFFING REQUIREMENTS

Role: Nutrition Program Manager

Requirements: Background in dietetics, nutrition, or food service management

Role: Meal Delivery Driver

Requirements:

• Valid driver’s license and clean driving record
• Food safety certification
• Background check and TB clearance

Training Requirements:

• Food handling and safety regulations
• Infection control and hygiene protocols
• Client communication and service documentation
• Emergency response and dietary risk management

7. MEDICAID WAIVER SERVICES

Home Delivered Meals Services in Missouri are available through:

• Aged and Disabled Waiver (ADW)
• Independent Living Waiver
• Medically Fragile Adult Waiver

Approved providers may deliver:

• Nutritious meals tailored to medical and dietary needs
• Safety checks during meal delivery
• Nutritional guidance and meal planning support

8. TIMELINE TO LAUNCH

Phase: Business Formation

Timeline: 1–2 weeks

Phase: Medicaid Provider Enrollment

Timeline: 60–90 days

Phase: Food Safety and Permit Acquisition

Timeline: 30–45 days

Phase: Staff Hiring and Training

Timeline: 30–45 days

9. CONTACT INFORMATION

Missouri Department of Health and Senior Services (DHSS)

Website: https://health.mo.gov

Missouri Department of Social Services (DSS)

Website: https://mydss.mo.gov

​

10. SCOPE OF WORK

• Business registration and licensing assistance
• Medicaid provider enrollment
• Policy & procedure manual for meal preparation and delivery operations
• Templates for meal logs, nutritional assessments, and delivery records
• Website, domain, and email setup
• Staff credentialing and food safety training documentation
• Client intake packet and dietary planning forms
• Risk management and infection control procedures
• Referral networking with healthcare providers and nutrition specialists