Medicaid Waiver 101

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Medicaid Waiver 101
Medicaid Waiver 101

• One Familys Experience

One Familys Experience
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Eligibility

• Parent income is not considered when determining
  eligibility for Waiver services.

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Eligibility

• Must meet criteria for placement in an
  institution to be eligible for waiver.
• This does not mean you must agree to an
  institution, just meet criteria.

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Home and Community Based Waivers in Virginia

• AIDS Waiver
• Consumer-Directed Personal Assistance Waiver
• Elderly and Disabled Waiver
• Individual and Family Development Disabilities
  Support Waiver
• Mental Retardation Waiver
• Technology Assisted Waiver

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Different Institutional Placements Have Different
Waivers

• Hospitals are alternatives to
• AIDS Waiver
• Tech Waiver

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Different Institutional Placements Have Different
Waivers

• Nursing homes are alternatives to
• AIDS Waiver
• CD-PAS Waiver
• ED Waiver
• Tech Waiver

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Different Institutional Placements Have Different
Waivers

• ICFs / MR are alternatives to
• DD Waiver
• MR Waiver

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History

• Home and community based waivers were established
  by the U.S. Congress to assist families who
  objected to institutionalization as the only way
  to receive support such as personal care and
  training.

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History

• In 1981, states were given the option to develop
  Waiver programs as an alternative for people who
  were eligible for institutional placement.

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MR Waiver Services

• Adult Companion (8 hours max./day Consumer
  directed and agency)
• Assistive Technology (5,000 max./year)
• Crisis Stabilization (60 days max./year)
• Day Support (780 units max./year of prevocational
  and supported employment units)
• Environmental modifications (5,000 max./year)

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MR Waiver Services

• Residential Support (Congregate, group home or
  persons home)
• Respite Care (720 hours max./yr. Consumer
  directed or agency)
• Skilled nursing services
• Supported employment (780 units max./yr. of day
  support and prevocational units)
• Therapeutic consultation

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MR Waiver Benefits to the child and family

• Environmental modification up to 5,000 each
  year
• The environmental modification can be used to
  make modifications to your home to make it more
  accessible and safer for your child.
• Fencing, accessible deck/ramp, accessible bathroom

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MR Waiver Benefits to the child and family

• Assistive technology - 5,000 year
• Assistive technology can be used to provide
  equipment to help the child to be more mobile
  provide learning aids provide communication
  aids.
• Special strollers/wheelchairs, Go-Talk Boards,
  touchscreen computers, specialty software

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Wicycle
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Maclaren Special Needs Stroller
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MR Waiver Benefits to the child and family

• Residential Support
• Support provided to the child to work on specific
  goals and self help skills.
• Residential support worker can accompany family
  on outings to assist child with meeting goals and
  self help.

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MR Waiver Benefits to the child and family

• Respite Care up to 720 hours a year
• Respite Care provides care for your child while
  the family runs errands, has a day out, or just a
  much needed break.
• Respite worker can accompany family on vacation /
  outing to assist with child.

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MR Waiver Benefits to the child and family

• Personal Assistance (Consumer directed and
  agency)
• Provides a person to assist in the care of your
  child.

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MR Waiver Benefits to the child and family

• Easier access to equipment and modifications
  necessary for continued independence.
• Access to professionals to assist in continuation
  of meeting goals to achieve maximum potential.

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MR Waiver Benefits to the child and family

• The major benefits our family has seen with this
  program is increase in independence for our child
  with disabilities, time to be able to focus on
  our other two children and the ability to more
  easily have whole family time together.

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