DDA Home and Community Based Services HCBS Waiver

DDA Home and Community Based Services (HCBS) Waiver Overview for AFH Staff

Ann Vasilev Waiver Services Unit Manager: (360) 407 -1551 Ann. Vasilev@dshs. wa. gov

What an HCBS Waiver is • The HCBS waiver program began in 1981 as a means to correct the “institutional bias” of Medicaid funding • The “bias” was that federal funding was only available to support individuals living in institutions rather than the community.

Waiver Basics • Under Section 1915 (c) of the Federal Social Security Act, states are permitted to request a waiver of their Medicaid state plans. • The waiver allows states to offer additional services and supports, not available under the state plan, which enable individuals to live in the community rather than in institutional settings.

Waiver Basics continued • These waivers are called Home and Community Based Services (HCBS) Waivers by the federal government and are administered by the Center for Medicare and Medicaid Services (CMS). • Participants in federal waiver programs must meet an institutional level of care and choose to live in the community rather than an institution. • States must assure that the cost of waiver services will not exceed the cost of institutional services.

Waiver Eligibility The individual is a client of DDA; and The individual has a disability according to criteria established in the Social Security Act; and The individual’s gross income does not exceed 300 percent of the SSI benefit amount, and the individual’s resources do not exceed $2, 000; Parental income is not considered for children; and The individual is assessed to need an institutional level of care (ICF/IID LOC).

Waiver Eligibility continued A Person-Centered Service Plan (PCSP) identifies: Unmet health and welfare needs (the red flowers *); and Services to meet the individual’s health, safety and habilitation needs in the community; and At least one waiver service or monthly monitoring The individual has agreed to accept home and community-based services as an alternative to institutional services (by signing the voluntary participation statement Form #10 -424)

DDA’s HCBS Waivers • DDA offers services under five waivers today: v. Basic Plus v. Children's Intensive In-Home Behavioral Supports (CIIBS) v. Core v. Community Protection (CP) v. IFS Waiver • Each waiver is designed to serve a specific group of individuals to access supports in their community that are not available through any other resource (insurance, school, etc. )

DDA’s HCBS Waivers • Services under four waivers can be accessed together with Community First Choice (CFC) State Plan services: v. IFS Waiver v. Basic Plus v. Children's Intensive In-Home Behavioral Supports (CIIBS) v. Core (non-residential)

Basic Plus Waiver • The individuals on this waiver may live with family or in their own homes • Individuals may live in an adult family home or adult residential care (Assisted Living) facility. • They meet ICF/IID level of care guidelines and are at high risk of out-of-home placement or loss of current living situation system. • The family/caregiver’s ability to continue caring for the individual is at risk; but can be continued with the addition of services.

Basic Plus Waiver Services for individuals in an AFH Positive Behavior Support and Consultation (soon to be specialized habilitation) Community Guide Extended State Plan services (Adult Only): Occupational Therapy Physical Therapy Speech, Hearing and Language Services Risk Assessment Specialized Equipment and Supplies Skilled Nursing (including Nurse Delegation for respite) Employment support programs: Supported Employment Community Inclusion Emergency Assistance Wellness Education Respite (Agency, Community, IP or RN/LPN) Behavioral Health stabilization Crisis Supports: in home or out of home Transportation (to a waiver service) Staff & Family Consultation

Regional Waiver Specialists • Region 1: • Lisa Braas, 509/329 -2905, Lisa. Braas@dshs. wa. gov • Sarah Kennedy, 509/374 -2121, Sarah. Kennedy@dshs. wa. gov • Region 2: • Shan-Shan Chien, 206/568 -5555, Chien. SS@dshs. wa. gov • Sheila Collins, 206/568 -5724, Colli. SE@dshs. wa. gov • Kate Flaming, 206. 568. 5641, kate. flaming@dshs. wa. gov • Region 3: • Judith Miller, 360/725 -4303, Weathjd@dshs. wa. gov • Jennifer Laughlin, 253/404 -5559, laughjs@dshs. wa. gov

DDA Waiver Program Manager Contacts • Ann Vasilev, Waiver Services Unit Manager, ann. vasilev@dshs. wa. gov or 360 -407 -1559 • Bob Beckman, Waiver Requirements Program Manager, bob. beckman@dshs. wa. gov or 360 -407 -1555 • Michelle Hoffman, CIIBS/SSP Program Manager, michelle. hoffman@dshs. wa. gov or 360 -407 -1553 • Leila Graves, IFS Program Manager, Leila. graves@dshs. wa. gov or 360 -407 -1529

Resources • 388 -845 Washington Administrative Code (WAC): http: //apps. leg. wa. gov/WAC/default. aspx? cite=388 -845 • DDA internet site: https: //www. dshs. wa. gov/dda/consumers-andfamilies/home-and-community-based-waivers-hcbs • DDA Service Request and Information: https: //www. dshs. wa. gov/dda/service-and-informationrequest