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In this episode, we talk with 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. 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. Resources in this episode: Missouri Department of Mental Health – Division of Developmental Disabilities Website: https://dmh.mo.gov/dev-disabilities [https://dmh.mo.gov/dev-disabilities] Learn more about Missouri’s Home and Community Based Services: https://dmh.mo.gov/dev-disabilities/service-providers/hcbs-info [https://dmh.mo.gov/dev-disabilities/service-providers/hcbs-info] Missouri Department of Mental Health Website: https://dmh.mo.gov/ [https://dmh.mo.gov/] DDD Weekly Newsletter Blast - Link to subscribe: https://lp.constantcontactpages.com/sl/IZJqgUz [https://lp.constantcontactpages.com/sl/IZJqgUz] Acronym Guide: HCBS: Home- and Community-Based Services IDD: Intellectual and Developmental Disabilities ICF/IID: Intermediate Care Facility for Individuals with Intellectual Disabilities DD: Developmental Disabilities DMH: Department of Mental Health TCM: Targeted Case Management HUD: U.S. Department of Housing and Urban Development Interview Transcript: ihd.umkc.edu/products For more information about UMKC-Institute for Human Development, visit ihd.umkc.edu
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