What Is the Home and Community Based Services (HCBS) Medicaid Waiver?
The HCBS Waiver is a funding mechanism that enables a person to obtain the supports and services needed to obtain his or her goals in life. A persons independence and inclusion in the community are the primary concern in designing this package of supports and services.
The HCBS Waiver:
Provides Medicaid funding for certain services which, in the absence of the waiver, are Medicaid-funded only for persons admitted to an Intermediate care Facility for the Mentally Retarded (ICF/MR);
Eliminates including parental income for Medicaid eligibility for person under the age of 18 who live with their parents.
What Services are Available Under the HCBS Waiver?
The following services are available under the HCBS Waiver and may be provided by a DDSO or any not-for-profit agency that has a Medicaid Provider Agreement to provide Waiver services:
RESIDENTIAL HABILIATION
A service that provides assistance to acquire, retain, or improve the skills needed to perform daily activities in the home. These activities can include housekeeping, personal care, meal preparation, communication, health care, and social engagements.
DAY HABILITATION
A service that provides assistance to acquire, retain, or improve the skills needed to perform daily activities away from home. These activities might include purchasing goods and services, communicating with fellow employees, traveling, community meetings or gatherings, or running errands.
SUPPORTED EMPLOYMENT
A service which provides competitive work in integrated settings for individuals for whom competitive employment has been interrupted or intermittent as a result of their disabilities, and need ongoing services to continue to work.
PREVOCATIONAL SERVICES
A service that prepares individuals for paid or unpaid employment. Services include teaching such concepts as attending, task completion, problem solving and safety. Activities included in this category are not primarily directed at teaching specific job skills, but are directed at underlying habilitative goals, such as increase attention span and improving motor skills.
RESPITE
A service that provides short term “substitute services” on behalf of a primary care giver who is either a family member, a legal guardian, an advocate, or a Family Care Provider or live-in/house parent staff. It is a means of providing services when the person who normally provides care is absent or in need of relief.
- Hourly- Occurs in a persons home, Family Care home, or OMRDD certified or approved site.
- Residential- Overnight stay in an OMRDD operated, certified, or approved site that is not a private residence.
ADAPTIVE DEVICES
Devices, aids, controls, appliances, or supplies of either a communication or adaptive type, which are necessary to enable the person to increase or maintain his or her ability to live at home with independence and safety. Some examples are personal emergency response systems, communicators, speech amplifiers, standing boards/frames, and motorized wheelchairs.
ENVIRONMENTAL MODIFICATIONS
Changes and/or additions to the home environment necessary to ensure the health, welfare, and safety of the individual with developmental disabilities; or to enable the individual to function with great independence in the home. Some examples are ramps, lifts, hand-railings, roll-in showers, water faucet controls, and cabinetry.
PLAN OF CARE SUPPORT SERVICES
This service will only be provided to people who are participating in the HCBS Waiver and who have chosen to withdraw from Medicaid Service Coordination. The major responsibilities for staff providing this service will be maintaining the determination is completed, and assuring that necessary safeguards have been taken to protect the health and welfare of the consumer.
SELF-DIRECTED & INDIVIDUALIZED SUPPORTS
Self-directed care/individualized care, often referred to as consumer-directed services, is a practice that enables the individual the right and ability to assess their own needs and determine who and how these services will be provided. Consolidated Supports and Services is a means for an individual to hire and fire their own staff using Home and Community Based Services (HCBS) waiver money.
FAMILY EDUCATION AND TRAINING
This service may be provided to the families of consumers enrolled in the HCBS Waiver who are under 18 years of age. The purpose of family education and training is to enhance the decision making capacity of the family unit, provide orientation regarding the nature and impact of developmental disabilities upon the consumer and his or her family, and inform them about service alternatives.
Who is Eligible to Participate in the HCBS Waiver?
- Has a documented developmental disability.
- Has needs comparable to a person residing in an Intermediate Care Facility.
- Enrolled in Medicaid.
- Living in either a Family Care home, their own, an Individual residential Alternative, or a Community residence.
- The DDSO has available funds.
BACK to Service Coordination