What is a Medicaid Waiver?
The Medicaid Waiver program began in 1981, in response to the national trend toward providing Home and Community-Based Services (HCBS). In the past, Medicaid paid only for institutionally based long term care services, such as nursing facilities and group homes.
The goals of waiver services are to provide to the person meaningful and necessary services and supports, to respect the person's personal beliefs and customs, and to ensure that services are cost-effective. Specifically:
Waivers for individuals with a developmental disability assist a person to:
- Become integrated in the community where he/she lives and works
- Develop social relationships in the person's home and work communities
- Develop skills to make decisions about how and where the person wants to live
- Be as independent as possible
There are 3 Ohio Waivers, but a person can only be receiving one. In order to receive waiver services, an individual must be eligible for Medicaid.
Types of Ohio Waivers
* Self Empowered Life Funding (SELF Waiver)
* Individual Options Waiver (I/0 Waiver)
* Level One Waiver (L1 Waiver)
An application has must be completed with your County Board of Developmental Disabilities (DD). A staff from your Board of DD will assist you with the intake process.
Contacts at Ohio County Boards of Developmental Disabilities
A waiver must be renewed annually, which you will do with your County Board. It is important to know that if you are enrolled on a waiver, you must also meet Medicaid eligibility every month to continue with waiver services.
There are waiting lists that extend out for a few years. It is important to have your name on the list to receive these funds. Even at a young age, it is important to be added to the list, so that as transition occurs into adult life, these waivers may provide additional opportunities.
All About Waiting Lists Handbook (from DODD website)
Currently Michelle P Waiver services are being offered to individuals with urgent needs, and those on the "Supported for Community Living (SCL)" waiting list beginning with those who have been on the waiting list the longest.
NorthKey Community Care will conduct the assessments. Eligible individuals will receive a letter from the Department for Medicaid Services and their names will then be given to North Key.
Kentucky Department for Medicaid Services
Indiana applies for permission to offer Medicaid Waivers from the Centers’ for Medicare and Medicaid Services (CMS). The Medicaid Waivers make use of federal Medicaid funds (plus state matching funds) for Home and Community-Based Services (HCBS), as an alternative to institutional care, under the condition that the overall cost of supporting people in the home or community is no more than the institutional cost for those people.
DDRS oversees two waiver programs, the Community Integration and Habilitation Waiver and the Family Supports Waiver.
Community Integration and Habilitation (CIH) Waiver
CIH is a combination of the Autism and the Developmental Disability Waivers and provides services that enable persons to remain in their homes or in community settings and assists transitions from institutions into community settings. This is a needs-based waiver and is designed to provide supports for persons to gain and maintain optimum levels of independence and community integration while allowing flexibility in the provision of those supports.
Family Supports Waiver (FSW)
Formerly the Support Services Waiver, the FSW is designed to provide limited, non-residential supports to persons with developmental disabilities residing with their families, or in other settings with informal supports.
Home & Community Based Medicaid Waivers (CIH and FSW)
- Community Integration and Habilitation Waiver (CIH) Effective October 1, 2014
- Family Supports Waiver (FSW) Effective June 1, 2014
Who can receive waiver services?
To receive a Medicaid Waiver you must meet both the criteria for a developmental disability and ICF/ID-DD level of care. The criteria for a developmental disability is defined in state law and means that a qualifying developmental disability is evident and that it was diagnosed by a medical doctor prior to age 22. ICF/ID-DD Level of Care means that an individual qualifies as deficient in at three of the functional limitations designated in the Code of Federal Regulations.
How do I apply for a Family Supports Waiver?
The Bureau of Developmental Disabilities Services District Offices can provide an application for the Family Supports Waiver as well as assist in researching additional services. Once it has been determined that an individual meets the criteria for a developmental disability, that individual will be placed on the appropriate waiver waiting lists. Once a waiver slot becomes available the individual will be offered a waiver placement.
BDDS District Offices
The Bureau of Developmental Disabilities Services (BDDS) is a program of the Division of Disability & Rehabilitative Services,a division of the Indiana Family & Social Services Administration.
1452 Vaxter Avenue
Clarksville, IN 47129-7721
Toll Free: 1-877-218-3529 (V/VRS/711)
Toll Free Fax: 1-855-525-9376
- Counties: Bartholomew, Brown, Clark, Crawford, Dearborn, Decatur, Floyd, Harrison, Jackson, Jefferson, Jennings, Lawrence, Ohio, Orange, Ripley, Scott, Switzerland & Washington.