Enhanced Systems of


Children and Adults in the St. Louis region who have an Intellectual and Developmental Disability or are dually diagnosed with a mental illness and:

  1. Has severe psychiatric or behavioral symptoms that place the individual or others at imminent and significant risk of harm, or threaten the sustainability of the current community placement
  2. Have had at least two crisis episodes in the last 4-6 months that require an ER visit, psychiatric inpatient admission, or legal involvement
  3. Chronic use of enhanced supports that have been unsuccessful in reducing crisis episodes
  4. Reliance on multiple psychotropic medications to attempt to regulate behavior

Aside from the diagnosis of an intellectual and developmental disability or dual diagnosis, Members must have experienced two or more crisis events within the last four months with each event requirements at least one of the following:

  • Call/s to mobile crisis or law enforcement
  • Utilization of crisis stabilization services (ie: behavioral respite)
  • Hospitalization in an acute psychiatric setting and/or ER intervention

Members who qualify for this service will have already been involved in services, supports, or treatment interventions that have not been effective in preventing or stabilizing crisis events.. Ineffective services or treatment may include medication management, outpatient psychotherapy, and behavior services

Members receiving services, and their providers and supports will have access to a 24/7 crisis line to assist in preventing or managing crises or escalating situations. The on-call clinical staff will work to resolve the crisis by phone or by an in-person visit to the Member, generally within two hours. Crisis prevention will be targeted using the Person-Centered Multi-system Crisis Prevention Plan.

You can send a referral to esos@personcenteredsupports.com. The referral will be forwarded to the Missouri Department of Mental Health, Division of Developmental Disabilities for review. If you need a copy of the referral form, you can download a copy here

ESOS is funded through the General Revenue stream from the state of Missouri. This is not funded via a waiver or Medicaid.

  • 24/7 Crisis response, support, and stabilization including on-call and mobile response
  • Development of Person-Centered Multi-System Crisis Support Plan (Crisis Safety and Distress Tolerance Plan)
  • Community linkages, referral, coordination, and collaboration with additional providers, respite, or inpatient services when necessary
  • Individualized assessment to identify and facilitate interventions that result in measurable reductions in crisis events and the need for out-of-home placement

If the Missouri Department of Mental Health, Division of Developmental Disabilities supports the referral, please download the referral form here. Referral forms should be returned to esos@personcenteredsupports.com