Our guest today is Sheila Wunning, Director of the Division of Developmental Disabilities at the Missouri Department of Mental Health. Sheila has worked in the field of developmental disabilities since 1996, with experience spanning community-based services, targeted case management, behavioral health supports, and state-operated programs. Before entering the developmental disability field, she worked within the criminal justice system and saw firsthand how individuals with developmental disabilities and behavioral health needs often became trapped in cycles of incarceration without appropriate supports in place. Her career has included leadership roles at Options for Justice, the St. Louis Office for DD Resources, and the Missouri Department of Mental Health, where she became Division Director in 2025.
In this conversation, we explore recent federal and state Medicaid conversations, how Missouri’s developmental disability system is structured, and what these changes could mean for individuals with intellectual and developmental disabilities (IDD), families, providers, and communities. Sheila also shares insights from her experience across systems and discusses the importance of home- and community-based services, early intervention, and cross-system collaboration.
Meet Our Guest
Sheila Wunning
Division Director, Missouri Department of Mental Health – Division of Developmental Disabilities
Wunning has worked in the field of Developmental Disabilities since 1996 and has expertise in Targeted Case Management, Home and Community Based Waivers, and habilitation services. Sheila has worked in both state-operated and community support areas of the Division, which allowed her to gain an understanding of developmental disability facilities, division budgets, and federal regulations.
Wunning started her career after graduating college at the St. Louis County Jail and soon realized that many individuals entering the criminal justice system had developmental disabilities and/or behavioral health diagnoses — and that these individuals often had difficulty navigating the system, becoming trapped in a cycle of jail, probation, jail, prison, etc.. To proactively help people get the supports they needed to break or avoid this cycle, Wunning joined a small, SB40-funded agency in St. Louis called Options For Justice as a Case Coordinator. She then spent 11 years at the St. Louis Office for DD Resources, the SB40 Board for St. Louis City, starting as a Service Advocate. From there, she held various positions, including Director of Horizon Club, a HUD-funded Safe Haven project with a drop-in center for individuals experiencing homelessness and transitional housing for individuals with IDD and/or co-occurring MI/SUD that met federal criteria for chronic homelessness.
Wunning ended her time with DD Resources as the Director of Targeted Case Management and joined the Division of DD in 2017 as Superintendent of St. Louis Developmental Disabilities Treatment Centers, an ICF/IID facility. At the Division, she has also served as Assistant Division Director for the East Region/statewide TCM and Deputy Division Director of State Operated Programs, moving into the Division Director role in May of last year.
Episode Details
Key Takeaways
- Missouri’s Division of Developmental Disabilities supports approximately 44,000 individuals through a combination of home- and community-based services, targeted case management, crisis supports, and state-operated programs.
- Medicaid plays a critical role in funding services and supports for individuals with IDD, including home- and community-based services that help people live independently in their communities.
- Common misconceptions about Medicaid often overlook the complexity of disability services and the importance of long-term supports for individuals and families.
- Community-based services can help prevent unnecessary hospitalization, institutionalization, and involvement with the criminal justice system.
- Individuals with IDD and co-occurring behavioral health needs often face gaps in services that require stronger collaboration across disability, behavioral health, healthcare, and justice systems.
- Early intervention, crisis stabilization, and proactive supports can significantly improve outcomes and quality of life for individuals with complex needs.
- Innovation within Missouri’s developmental disability system includes expanded crisis response efforts, psychiatric stabilization supports, and partnerships across agencies and providers.
Acronym Guide
DD: Developmental Disabilities
DMH: Department of Mental Health
HCBS: Home- and Community-Based Services
HUD: U.S. Department of Housing and Urban Development
ICF/IID: Intermediate Care Facility for Individuals with Intellectual Disabilities
IDD: Intellectual and Developmental Disabilities
LEND: Leadership Education in Neurodevelopmental Disabilities
TCM: Targeted Case Management
UCEDD: University Center for Excellence Developmental Disabilities
Resources
Links
- Learn more about Missouri’s Home and Community Based Services
- Missouri Department of Mental Health (MO-DMH) Website
- MO-DMH – Division of Developmental Disabilities Website
