Description: The overall goal of this project is to assess the impact of the PfH Medicaid Waiver at the state, county, family, and individual levels. This project includes an in-depth examination of the impact of PFH on family quality of life as well an analysis of the statewide fiscal and economic impact of PfH funding in Missouri.


Project Contact:               George S. Gotto, Ph.D., 816-235-5334,                                           

Project Period:                   2012-2017
Project Funding:             
$200,000 (FY2014)
Funding Source:              
Missouri Department of Mental Health


Core Functions

Applied Research:  In-depth interviews were conducted with professionals who direct and administer services through Partnership for Hope (PfH), individuals who participate in PfH, and families. Interview results guided the development of products to assist in service implementation and utilization.

Community Services and Supports: The Community Services Team work closely with the project partners and additional community agencies to assess several aspects of PfH to improve program efficiency and service quality.

Information Dissemination:User-friendly informational guides have been prepared and disseminated to professionals and families. Journal articles have been drafted for publication. Findings have been presented at national conferences. Quarterly and annual reports are produced and disseminated to stakeholders.


Program Need and Historical Context: In 2007 the Missouri Association of County Developmental Disabilities Services (MACDDS) received a grant from the Missouri Foundation for Health to study state Medicaid and Medicaid waivers with the goal of increasing access to needed services for individuals with developmental disabilities across Missouri. As a result of this study and recommendations, the Partnership for Hope Waiver (PfH) was created. PfH is funded through a partnership of the Centers for Medicare and Medicaid Services, the Departments of Mental Health and Social Services, and County Boards for Developmental Disabilities. As a unique program tailored to the needs of Missourians, an evaluation was necessary to assess efficacy of program administration and impact of the waiver at the state, county, family, and individual levels.


Consumer and Community Involvement: The research team assembled a steering committee, comprised of members who represent primary constituencies involved with the development, implementation, and evaluation of the PfH Waiver, to meet quarterly with the evaluation team and provide guidance and feedback on project activities.





Figure 1

Significant Project Activities and Outcomes

  • Conducted focus groups and interviews with 46 professionals, 32 family members, and 14 individuals.
  • Retrospective or pre-/post- Family Quality of Life (FQoL) surveys are being disseminated to all PfH participants based on enrollment date.
  • Results from the retrospective FQoL survey show a statistically significant difference in the “before PfH” Family Quality of Life (FQOL) score and the “after PfH” (FQOL) score.
  • All five FQOL domains had a statistically significant increase in scores from “before PfH” to “after PfH.” Additionally, families reported very high overall satisfaction with PfH (Figure 1).
  • Statewide economic impact evaluation of PfH expenditures using IMPLAN Group, LLC data and software(see Figure 2).


  • “Partnership for Hope: What is it and how can it help me?” is a user-friendly brochure for professionals, families, and individuals on PfH services and how to enroll.
  • “What is the Partnership for Hope Medicaid Waiver? A Reference Guide for Professionals”—an in-depth, though user-friendly, guide to PfH for professionals
  • 2 annual reports
  • 7 quarterly reports
  • 2 national conference presentations
  • 3 peer-reviewed articles in progress