Transcript Medicaid Waiver 101 - Infant & Toddler Connection of Virginia

Medicaid Waiver 101
One Family’s Experience
Medicaid
Waiver 101
One Family’s Experience
Eligibility
• Parent income is not considered when
determining eligibility for Waiver
services.
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.
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
Different Institutional
Placements Have Different
Waivers
• Hospitals are alternatives to:
– AIDS Waiver
– Tech Waiver
Different Institutional
Placements Have
Different Waivers
• Nursing homes are alternatives to:
–
–
–
–
AIDS Waiver
CD-PAS Waiver
E&D Waiver
Tech Waiver
Different Institutional
Placements Have
Different Waivers
• ICFs / MR are alternatives to:
– DD Waiver
– MR Waiver
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.
History
• In 1981, states were given the option
to develop Waiver programs as an
alternative for people who were
eligible for institutional placement.
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)
MR Waiver Services
• Residential Support (Congregate, group
home or person’s 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
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
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
Wicycle
Maclaren Special
Needs Stroller
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.
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.
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.
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.
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.